A rare case of abnormal narrowing and bifurcation of descending thoracic aorta and perioperative anaesthetic management during aortic bypass surgery

Abstract

Hypertension in paediatric population is an emergent global health issue, where the prevalence is varied among nations. Although vascular pathologies are one of the causes for secondary hypertension, mid aortic anomalies are not seen commonly. These patients usually present with uncontrolled hypertension or hypertension emergency or hypertension associated organ dysfunction. Medical management per se will be not enough to achieve a satisfactory control in blood pressure and most of them will have to undergo either surgical repair or an endovascular procedure. Perioperative management of these patients is a challenge to an anaesthetist due to multiple reasons such as haemodynamic instabilities, organ dysfunction, metabolic derangements and the need for invasive monitoring.Here we present an 8 years and 10 months old boy who was investigated for hypertension and found to have abnormal narrowing and bifurcation of the descending aorta at T10 level and underwent successful aorto-aortic bypass surgery.