Repeated cardiac arrests in a child due to severe aortic flow
obstruction by Aortic cannula: A fatal complication
Abstract
In neonates and children the blood vessels are small in calibre and the
correct choice of arterial and venous cannulas together with accurate
placement are crucial to avoid obstructing vascular branches,and
misdirecting flow or impairing venous drainage.Normally in children, to
establish the cardiopulmonary bypass (CPB)one arterial cannula is
inserted inthe ascending aorta,and single stagevenous cannulae, where
two cannulae inserted into the superior and inferior vena cava and
joined by the Y-pieceare used in the most open-heartsurgeries to
facilitate the circulatory, respiratory support along with the
temperature management. Rarely aortic cannulation can lead to aortic
dissection, aortic posterior wall rupture leading to trauma to the
esophagus, dislodgement of the aortic atheroma, fatal bleeding leading
even to cardiac arrest. In addition, SVC and IVC syndrome can also occur
due displacement or obstruction by the venous cannulae. However,
repeated cardiac arrestsin childrenafter successful weaning from
CPB,even with the use of an appropriate size aortic cannula has not been
reported in the literature to date. We wish to discuss this fatal
complicationafter weaning from CPB, due to aortic flow obstruction due
to aortic cannula in a one-year-old, 5.5 kg child following
successfulventricular septal defect(VSD) repair. The international
review board approval or waiver and clinical trial registrations are not
applicable for this case report publication