Chap 150 Renovascular Anomalies Flashcards
what is middle aortic syndrome?
abdo aortic coarctation and hypoplasia
Where is MAS most often located
suprarenal then infra
What are associated disorders with MAS?
Neurofibromatosis-1, (25% of abdo ao coarc have NF-1 Williams syndrom, alagille syndomr Maternal rubella Takayasu (more likely arch or DTA Umbilical artery catheterization
What vessels have associated stenosis?
Splanchnic 87%
RA 62%
Usually ostial
what are symptoms of MAS?
Lower extremity fatigue is infrequent Intestinal angina 6% Food aversion, weight loss HTN HA, seizure, epistaxis, visual disturances, AKI, bell’s palsy Hemorrhagic stroke, HTN encephalopathy, FTT LVH Flash pulmonary edema
What is surgical management of MAS?
patch angioplasty
reimplant of visceral vessels
TA bypass
What size graft to use for bypass at different ages?
8-12mm children
12-16 early ADOLESCENTS
14-20 late adolescents and adults
When does axial growth stop?
age 9-10
How and when do you repair renal artery in children?
after age 3
internal iliac
(SV has aneurysmal degen)
What is the definition of HTN in children?
SBP or DBP >/= 95th percentile for sex age and hgt on 3 separate occasions