An infant with suspected missed diagnosis of Williams syndrome failed weaning off CPB after surgical correction of pulmonary stenosis: a case report and literature review

Perfusion. 2023 Jan;38(1):203-207. doi: 10.1177/02676591211046876. Epub 2021 Sep 18.

Abstract

Williams syndrome (WS) is a rare congenital developmental disorder caused by the deletion of between 26 and 28 genes on chromosome 7q11.23. For patients with WS, in view of the particularity of the supravalvular aortic stenosis, choosing appropriate arterial cannula, maintaining higher perfusion pressure as well as strengthening myocardial protection during cardiopulmonary bypass (CPB) is essential to the clinical outcome. Here, we report a child with pulmonary artery valvular stenosis who failed to wean off CPB because of malignant arrhythmias and cardiac insufficiency after surgical correction of pulmonary valvular stenosis. With the assistance of extracorporeal membrane oxygenation (ECMO), emergency cardiac catheterization revealed supravalvular aortic stenosis (SVAS), which suggests a suspected missed diagnosis of WS. Finally, under the support of ECMO, the cardiac function gradually returned to normal, and the child was discharged 23 days after surgery.

Keywords: ECMO; Williams Syndrome; cardiac surgery; cardiopulmonary bypass; pulmonary stenosis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Aortic Stenosis, Supravalvular* / diagnosis
  • Aortic Stenosis, Supravalvular* / surgery
  • Cardiopulmonary Bypass
  • Child
  • Constriction, Pathologic
  • Humans
  • Infant
  • Missed Diagnosis
  • Pulmonary Valve Stenosis* / diagnosis
  • Pulmonary Valve Stenosis* / surgery
  • Williams Syndrome* / complications
  • Williams Syndrome* / diagnosis
  • Williams Syndrome* / surgery