Awareness of abdominal aorta abnormalities in pediatric patients is essential for appropriate diagnosis and management of the patients suffering from these conditions. Due to a nonspecific presentation, and sometimes being asymptomatic earlier in life, imaging has an important role in diagnosis of these abnormalities. Aneurysm and dissection are excluded, as they are not specific to children and with few exceptions mostly present in older patients. We review the clinical presentation and show imaging findings of mid aortic syndrome, Takayusu arteritis, rare entities such as idiopathic infantile arterial calcification. Also we show imaging of the anatomic variants of the distal aorta such as middle sacral artery, persistent sciatic artery, abdominal aorta coarctation and blind ending aorta, with a short review of embryologic development of abdominal aorta. These anomalies are not common, however if remain undiagnosed might have serious consequences. -Midaortic syndrome is an uncommon disease with progressive narrowing of the abdominal aorta and its major branches, typically involving interrenal segment of the aorta; it affects mostly children and young adults, the cause is not clear, might be the result of an intrauterine insult to the intima and subintimal tissues. Aside from diagnosis, imaging has a major role in endovascular treatment of mid aortic syndrome. -Takayusu arteritis, also predominantly involves aorta and its major branches of younger patients, with strong female predominance, and frequently found in Asian patients. Destruction of arterial medi leads to aneurysm formation and uncommonly rupture of the involved artery. -Idiopathic infantile arterial calcification, a rare entity presenting with extensive calcification and stenosis of large and medium sized arteries, usually leads to early death from coronary artery occlusion. -The aortoiliac variants are rare and not commonly discussed in the imaging literature. Some anomalies might be asymptomatic in young ages, but might complicate surgeries like heart, renal transplant, or hip surgery and increases the risk of morbidity and mortality. Some of these anomalies such as persistent sciatic artery need long term follow-up, given the possibility of aneurysmal degeneration. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Saadat Vandad, Chawla Soni, Chen Johnathan, Iskander Paul, Ghahremani Shahnaz

Keywords: Aorta, takayusu, midaortic

Orthotopic heart transplant (OHT) is the treatment of choice for patients with end-stage heart disease including pediatric patients. Imaging has an essential role in evaluation of the perioperative and postoperative heart transplant patients. Although some of the imaging is performed and interpreted by cardiologists, a substantial portion of images are read by radiologist, therefore radiologists must be familiar with common normal and abnormal posttreatment imaging features. Many end stage heart failure patients require circulatory support as a bridge to transplant, with a ventricular assist device or intra-aortic balloon pump. The ventricular assist devices specially increase the risk of infection, and intra-aortic balloon pump requires frequent radiographic monitoring to ensure appropriate placement in the proximal descending aorta, just distal to the left subclavian artery. Proximal placement may result in great vessel compromise and distal placement may cause occlusion of mesenteric and/or renal vasculature. Expected postoperative findings in the first few weeks after surgery included enlarged cardiac silhouette, small pneumomediastinum, pneumothorax, pneumopericardium, subcutaneous emphysema, small atelectasis, and mediastinal widening. Transplant-related complications are divide to: Early complications (0-30 days): pulmonary infection, interstitial and/or alveolar pulmonary edema, and allograft failure, also symptomatic pneumothorax, mediastinal hematoma, mediastinal infection, sternal dehiscence and vascular complications. Intermediate term complications (1-12 months): acute antibody related allograft rejection, acute cellular rejection (T-cell mediated response) which is the most common form of rejection, also tricuspid regurgitation, constrictive pericarditis, drug toxicity can happen in this time period. Late postoperative complications (>12 months): posttransplant lymphoproliferative disease, cardiac allograft vasculopathy, infection, kaposi sarcoma and other malignancies, aortic dissection, pseudoaneurysm formation, and thromboembolism. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Saadat Vandad, Loo Jerry, Chen Johnathan, Iskander Paul, Chawla Soni, Ghahremani Shahnaz

Keywords: OHT, Complications, Imaging