Author: Jessica Cerretani

Bypassing a narrowed midaorta with a living, growing graft

Midaortic syndrome is marked by narrowing of the middle section of the aorta.

By the time he arrived at Boston Children’s Hospital, the 6-month-old boy was near death from midaortic syndrome — a rare but life-threatening condition marked by narrowing of the middle section of the aorta, the largest artery in the body. It had left him with severe hypertension, acute kidney injury and heart failure. As cardiologists worked to stabilize him, the surgical team weighed the options.

With diminished blood flow to the chest, abdomen and lower limbs, a significant number of people with untreated midaortic syndrome die from complications by age 40. The condition can be treated surgically, traditionally with a prosthetic graft made from synthetic material to perform an aortic bypass. But synthetic grafts can pose a number of challenges in children.

“Synthetic grafts don’t grow with the patient, which means that multiple surgeries may be necessary through the years to ensure appropriate graft size,” explains nephrologist Michael Ferguson, MD, who was a member of this patient’s care team. “Artificial grafts also carry a higher risk of thrombosis and infection.”

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Robot-enhanced neurosurgery for nimbler seizure mapping

implanting electrodes for seizure monitoring, with robotic assistance
Scellig Stone and Joseph Madsen in surgery with the robot.

Head shaved, a little boy rests on the operating table, deep under anesthesia. His parents have brought him to Boston Children’s Hospital in hopes of determining the cause of his seizures. Now, neurosurgeons Scellig Stone, MD, PhD, Joseph Madsen, MD, and their colleagues in the Epilepsy Center are performing a procedure designed to monitor seizure activity in the 3-year-old’s brain.

But as the team members crowd around the table, they’re not alone. With the push of a button, a large robotic arm rotates and lowers right next to the boy’s head, helping the physicians pinpoint the precise location to drill. “This is a real game-changer,” murmurs one of the clinicians observing the surgery. “It’s going to transform the way we practice.”

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Could fecal transplants heal Crohn’s and colitis in children? Two trials are set to find out

two trials test fecal transplant in Crohn's and colitis in children

Could an exciting potential treatment for inflammatory bowel disease (IBD) be found in the gastrointestinal tract itself? That’s the theory behind a pair of new studies by Stacy A. Kahn, MD, which will investigate the potential role of fecal microbial transplant (FMT) in the treatment of Crohn’s disease and ulcerative colitis in children.

In IBD, the immune system attacks healthy cells in the digestive tract, triggering symptoms such as abdominal pain, fatigue, poor growth and bloody diarrhea. Children with IBD can also experience problems elsewhere in the body, including joint pain, liver disorders and eye inflammation.

Known colloquially as the “poop pill,” or “stool transplant,” FMT harnesses growing knowledge about the gut microbiota, the collection of bacteria and other microbes that populate our GI tract.

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