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PEDIATRICS Vol. 106 No. 3 September 2000, p. e36

ELECTRONIC ARTICLE:
Coarctation of the Abdominal Aorta and Renal Artery Stenosis Related to an Umbilical Artery Catheter Placement in a Neonate

Received Jan 3, 2000; accepted Apr 5, 2000.

Raymond D. Adelman* and Rose Ellen MorrellDagger

From * Phoenix Children's Hospital, Phoenix, Arizona; and Dagger  Oakland Children's Hospital, Oakland, California.

Umbilical artery catheters have been associated with thrombotic complications, such as partial or complete occlusion in the aorta, the renal arteries, and other blood vessels. There have been few reports of the long-term consequences of either symptomatic or asymptomatic thrombi. We report a patient, now 22 years of age, born with a normal aorta, who developed hypertension at the age of 2 months after use of an umbilical artery catheter. An intravenous pylegram and nuclear renal scan were compatible with occlusion of left renal artery and of the distal aorta. At 6 months of age, the patient presented with reduced femoral pulses. Angiography demonstrated an acquired coarctation of the abdominal aorta and renal artery stenosis. An abdominal ultrasound performed at 22 years of age revealed partial obstruction of the lower abdominal aorta and marked atrophy of the left kidney. This case underlines the importance of long-term follow-up studies of infants who have undergone umbilical artery catheterizations.

 Key words:  coarctation, renal artery stenosis, neonate, umbilical artery catheter, thrombosis.




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