Disorders of the Abdominal Aorta and Major Branches

Abstract

Pediatric vascular disease is heterogenous, rare, and requires an interdisciplinary approach to management. Definitive diagnosis and medical stabilization of the underlying disease process should be obtained preoperatively when feasible. Autologous grafts are the preferred conduit for reconstruction, but synthetic or allografts are acceptable, readily available, and may be sized to specification. Aneurysmal disease should be treated early to prevent complications of rupture, occlusive dissection, thrombosis, or embolization. Stenotic disease can usually be treated conservatively with medical management of hypertension, though vascular reconstruction is indicated for hypertension refractory to medical therapy, end-organ damage of the kidneys or heart, stroke, claudication, limb-length discrepancy, or intestinal ischemia.