Pediatric precision: navigating the complexity of mycotic pseudoaneurysms in ascending aorta post-atrial septal defect repair—a case report

This case report elucidates the exceptional rarity and intricacies surrounding mycotic pseudoaneurysms in the ascending aorta, specifically post-pediatric cardiac surgery. The case report presents a distinctive case of a 7-year-old female developing complications 10 days after atrial septal defect repair, characterized by sternal wound infection attributed to Pseudomonas aeruginosa. Imaging revealed a substantial pseudoaneurysm, necessitating a meticulous surgical strategy involving femoral cannulation, redo sternotomy, and adept management of intraoperative challenges, such as a fragile sternum and dense adhesions. The successful postoperative course, marked by weaning and comprehensive management, contributes significant insights into the evolving landscape of mycotic pseudoaneurysms in pediatric populations. The discussion delves into the historical context, mechanisms, and causative organisms, emphasizing the heightened vigilance required in the postoperative care of this vulnerable demographic. This report enhances our understanding of pediatric cases, underscoring the imperative for increased awareness and strategic management in addressing post-cardiac surgery complications.