Lethal Fungal Aortitis In Surgically Corrected Supravalvular Aortic Stenosis In A Child With Williams Syndrome

J Ayub Med Coll Abbottabad. 2023 Apr-Jun;35(2):320-323. doi: 10.55519/JAMC-02-10055.

Abstract

Williams syndrome (WS), is a multisystem disorder occurring in 1 in 10,000 live births with supravalvular aortic stenosis (SVAS) being the most common cardiovascular manifestation. We present the case of a 2.5 years old male, a known case of WS who presented with cognitive delay, a history of right-sided stroke and left hemiplegia. Echocardiography revealed severe SVAS with a gradient of 105 mmHg. The diameter of the Sino tubular junction was 4 mm. Computerized tomography angiogram showed diffuse stenosis of ascending aorta with intraluminal thrombus. At surgery, the ascending aorta was augmented with autologous pericardial patches and end-to-end anastomosis of the proximal and distal aorta completed the reconstruction. The patient was discharged in a stable condition. He presented 6 weeks post-op with a pulsating pseudoaneurysm through the sternal wound. Emergency surgery with the removal of fungal vegetation and reconstruction of the ascending aorta was performed. He expired due to fungal sepsis a week later.

Keywords: Supra valvular aortic stenosis; Infectious aortitis; Williams-beuren syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aorta
  • Aortic Stenosis, Supravalvular* / complications
  • Aortic Stenosis, Supravalvular* / diagnostic imaging
  • Aortic Stenosis, Supravalvular* / surgery
  • Aortitis*
  • Child
  • Child, Preschool
  • Echocardiography
  • Humans
  • Male
  • Williams Syndrome* / complications
  • Williams Syndrome* / surgery