Innominate artery aneurysm after cannulation for extracorporeal membrane oxygenation via the right carotid artery

Excerpt

The patient is a 6-year-old female who was cannulated via the right carotid onto veno-arterial extracorporeal membrane oxygenation for 6 days owing to ventricular tachycardia. Upon decannulation, there was noted to be dissection of the carotid artery, which was reconstructed with an interpositional graft. She developed Staphylococcus aureus bacteremia and endocarditis 2 weeks later, necessitating graft removal. Approximately 3 weeks after decannulation, she presented with recurrent airway obstruction and a widened mediastinum on chest X-ray (Fig. 1). Computed tomographic imaging of her chest revealed a large aneurysm of the innominate artery, compressing her trachea (Figs. 2, 3). The aneurysm was resected and a conduit was placed without complication. The etiology of her aneurysm is unclear, but likely related to the carotid artery dissection and Staphylococcus aureus endocarditis.

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