Surgical management of type IV thoracoabdominal aortic aneurysm in a 4-year-old child: A case report and review of the literature

Thoracoabdominal aortic aneurysms in children are rare, associated with syndromic, congenital, or acquired disorders, and can be life threatening. Although early intervention is advocated, optimal management remains undefined, and vessel size and aortic growth pose technical challenges. We report the case of a 4-year-old boy with type IV thoracoabdominal aortic aneurysm, celiac trunk occlusion, and stenoses of the superior mesenteric and renal arteries from inflammatory disease causing renovascular hypertension. He underwent thoracoabdominal bypass using a C-shaped Dacron graft, indirect reimplantation of the superior mesenteric artery and renal arteries with cryopreserved allografts, and orthotopic autotransplantation of the left kidney. The outcome was favorable, supporting open repair in selected pediatric patients.