Open Vascular Repair of Superior Mesenteric Artery Aneurysm in a Pediatric Patient with Rheumatic Triple Valve Insufficiency

Brent andrew G. Viray ¹, Alduz Inri S. Cabasa ², Gianina Kasandra A. Grey ², Gisel T. Catalan ²

¹ University of the Philippines-Philippine General Hospital Department of Surgery, Manila, Philippines; ² University of the Philippines-Philippine General Hospital, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Manila, Philippines, Manila, Philippines;

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – B

Abstract

OBJECTIVE We are reporting a rare case of a ruptured superior mesenteric artery aneurysms (SMAA) presenting with or as a consequence of rheumatic valvular heart disease. METHODOLOGY. A 15-year old female with severe abdominal pain subsequently underwent urgent exploratory laparotomy after initial temporizing medical management for congestive heart failure secondary to aortic, mitral and tricuspid insufficiency. A 6 cms SMAA aneuryrsm was noted with rupture of the posterior wall. Due to the likelihood of small bowel syndrome and a bypass was not possible, partial resection of the aneurysm wall and primary repair was done. A second look laparotomy showed no bowel compromise with an intact repair. RESULTS Postoperative course was unremarkable. Discharge plans included vascular surveillance as well as preparation for elective open heart surgery. CONCLUSION We are presented with a rare case of ruptured superior mesenteric artery aneurysm with rheumatic triple valve insufficiency successfully managed by open repair