Calcification of a Synthetic Renovascular Graft in a Child

Abstract

IntroductionVascular grafts, especially in paediatric cases, need to be durable. Common failures such as thrombosis are well documented with research efforts directed towards them. However, there are lesser known causes of graft failure, such as graft calcification, and these also require further research focus.ReportA paediatric case is described in which a synthetic renovascular graft, implanted for mid-aortic syndrome, became calcified, necessitating surgical intervention to resolve graft malfunction. Significant calcification in the limb of a bifurcated polyethylene terephthalate graft was found to be the cause of resistant stenosis and refractory hypertension. Histology conducted on the explanted limb showed the presence of multinuclear giant cells, indicating a chronic foreign body response.DiscussionCalcification of vascular grafts is probably more common than previously recognised. Stenosis typically resistant to angioplasty may result in the long term and thus leading to surgical intervention. In young children, this is suboptimal as these grafts need to last throughout adulthood. Explanted prosthetic grafts should be sent to specialist registries such as that in Strasbourg to be optimally assessed so that contributory factors can be identified.

Reconstructive vascular surgery in pediatric oncology: literature review

“…Chong et al представляют клинический случай ребенка с НБ 2-й стадии, который в возрасте 6 месяцев прошел химиотерапию (ХТ) и хирургическое лече ние [13]. В 7 лет у пациента в области оперативного вмешательства развивается стеноз почечных артерий с неконтролируемой гипертензией и окклюзия верх ней брыжеечной артерии.…”

“…В 7 лет у пациента в области оперативного вмешательства развивается стеноз почечных артерий с неконтролируемой гипертензией и окклюзия верх ней брыжеечной артерии. Выполнена реконструкция аорты с использованием раздвоенного ПЭТ-графта [13]. Рецидив стеноза с неконтролируемой артериаль ной гипертензией наступил в 11 и в 16 лет, что потребо вало повторной реконструкции сосудов, которая про водилась с использованием того же материала.…”

Diagnosis and Management of Genetic Causes of Middle Aortic Syndrome in Children: A Comprehensive Literature Review

“… 3 , 20–23 Other acquired causes of MAS include post-surgical fibrosis and damage of the vasa-vasorum after surgical resection of an abdominal tumor or impaired growth of the aorta after radiation therapy for neuroblastoma in children. 24 , 25 Takayasu arteritis is a chronic inflammatory disease with unknown precise etiology, with genetic factors’ involvement such as HLA genes and other proposed risk factors as genetic variants in genes encoding immune response regulators and pro-inflammatory cytokines. This form of MAS encountered in 15–18% of the cases.…”

Complex biomechanical study of chitosan microtubes

“…This is largely due to cardiovascular diseases, which are the most common in the world, especially in pediatric surgery, because modern synthetic prosthesis is incapable of adapting to an ever-growing, evolving organism [2]. The literature contains a large number of publications reflecting attempts to make transplants from synthetic polymers and biopolymers [3][4][5]. Nevertheless, not all existing models prostheses are close enough (for biomechanical properties) to the native arteries, leading to numerous operational complications caused by biomechanical incompatibility [6,7].…”