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Incidental finding of type A aortic dissection in a paediatric heart transplant recipient

Published online by Cambridge University Press:  27 August 2019

Laura D’Addese Open the ORCID record for Laura D’Addese [Opens in a new window] ,
Rukmini Komarlu  and
Kenneth Zahka
Laura D’Addese*
Affiliation:
Cardiology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
Rukmini Komarlu
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, OH, USA
Kenneth Zahka
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, OH, USA
*
Author for correspondence: Laura D’Addese, MD, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK. Tel: +44 (0) 749 389 2096; E-mail: Laura.D’Addese@gosh.nhs.uk
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Abstract

Aortic dissection causes significant morbidity and mortality in adults and treatment guidelines are based on well-documented risk factors. Conversely, dissection after orthotopic heart transplantation is very rare, especially in the absence of infection, hypertension, or donor–recipient aortic size mismatch. Several forms of CHD are associated with aortic dilatation, but the incidence of aortic dissection and aneurysm in children is also low, which makes use of adult guidelines in children challenging. We present a 17-year-old Amish female with a homozygous gene mutation in the MYBPC3 gene known to cause lethal, infantile hypertrophic cardiomyopathy. She underwent orthotopic heart transplantation and then developed an asymptomatic aortic dissection despite no known risk factors.

Keywords

Aortic dissectionheart transplantationAmishMYBPC3 genehypertrophic cardiomyopathy
Type
Brief Report
Information
Cardiology in the Young , Volume 29 , Issue 9 , September 2019 , pp. 1219 - 1221
Copyright
© Cambridge University Press 2019 

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References

Larson, EW, Edwards, WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol 1984; 53: 849–855.CrossRefGoogle ScholarPubMed
Fikar, CR, Fikar, R. Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York State. Clin Cardiol 2009; 32: E23–E26.CrossRefGoogle Scholar
Fikar, CR, Koch, S. Etiologic factors of acute aortic dissection in children and young adults. Clin Pediatr (Phila) 2000; 39: 71–80.CrossRefGoogle ScholarPubMed
Shamszad, P, Barnes, JN, Morris, SA. Aortic dissection in hospitalized children and young adults: a multi-institutional study. Congenit Heart Dis 2014; 9: 54–62.CrossRefGoogle Scholar
Stulak, JM, Dearani, JA, Burkhart, HM, et al. Does the dilated ascending aorta in adults with congenital heart disease require intervention? J Thorac Cardiovasc Surg 2010; 140: S52–S57.CrossRefGoogle ScholarPubMed
Vigano, M, Rinaldi, M, D’Armini, AM, et al. The spectrum of aortic complications after heart transplantation. Ann Thorac Surg 1999; 68: 105–111.CrossRefGoogle ScholarPubMed
Lang, SM, Frazier, EA, Collins, RT. Aortic complications following pediatric heart transplantation: a case series and review. Ann Pediatr Cardiol 2016; 9: 42–45.CrossRefGoogle ScholarPubMed
Hiratzka, LF, Bakris, GL, Beckman, JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010; 121: e266–e369.Google Scholar
Zahka, K, Kalidas, K, Simpson, MA, et al. Homozygous mutation of MYBPC3 associated with severe infantile hypertrophic cardiomyopathy at high frequency among the Amish. Heart 2008; 94: 1326–1330.CrossRefGoogle ScholarPubMed