Pediatric Cardiology Expert Discusses Botched Stent Repair

Case Overview

This case involves a male patient who suffered a devastating ischemic stroke shortly after undergoing an aortic stent repair for an aortic arch aneurysm. A covered stent was placed after aortic stenosis and a pseudoaneurysm were found. Subsequently, the stent fractured, and a piece lodged in the patient’s right leg. It was recommended that stainless steel stents be placed inside the fractured stent to hold it in place. After the procedure was completed, the patient was slow to emerge after extubation, and a nurse noted right hemiparesis. The neurology team was called to his bedside, and a CT scan revealed a cerebral artery infarction with possible anterior cerebral artery thrombus. The next day, he was discharged to another medical center after further scans demonstrated evolution of the cerebral artery infarction and anterior cerebral artery infarctions, as well as an occlusion of the right internal carotid artery. The patient suffered serious cognitive and neurological deficits from his stroke, and will require a lifetime of ongoing care.

Questions to the Pediatrics expert and their responses

Do you routinely treat patients like the one described in this case?

I am a board certified pediatric cardiologist who is specifically trained in invasive and interventional cardiology. I have performed 1500+ procedures on infants and children and adults with congenital heart disease and I have worked at large-volume medical centers for the duration of my career. I commonly treat patients presenting similar complications and I personally perform interventions on children and adolescents with this type of heart disease.

Based on the summary, is it possible that this patient might have had a better outcome had the care rendered been different?

My opinion is that it is certainly possible that the patient could have had a better outcome had different care been rendered.

About the expert

This highly qualified expert is double boarded in General Pediatrics and Pediatric Cardiology. He has been an elected Fellow 3 times with the American College of Cardiology, the American Academy of Pediatrics, and the Society for Cardiovascular Angiography and Interventions. He has received numerous awards for his work as a researcher, teacher, and clinician, and he has traveled nationally and internationally to present his work at numerous professional conferences. He currently serves as an Associate Professor of Pediatrics at a top-ranking University.

E-015592

Specialties:

Pediatrics