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She underwent successful surgical revascularisation by way of aorto-aortic bypass with a polytetrafluoroethylene graft and revascularisation of the superior mesenteric artery and both renal arteries by way of reimplantation for refractory hypertension despite four antihypertensives (ie, amlodipine, metoprolol, losartan and transdermal clonidine). At 18 months postoperatively, she is normotensive with a single agent, losartan, and has resolution of both left ventricular hypertrophy and symptoms. She follows with her multidisciplinary team with surveillance renal duplex and echocardiogram two times per year.<\/jats:p>","DOI":"10.1136\/bcr-2025-266584","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:20:33Z","timestamp":1786015233000},"page":"e266584","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Paediatric midaortic syndrome associated with ascending aortic and renal aneurysm managed with complex multidisciplinary medical management and surgical repair"],"prefix":"10.1136","volume":"19","author":[{"given":"Eden Sophia","family":"Singh","sequence":"first","affiliation":[{"name":"School of Medicine, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3654-7695","authenticated-orcid":false,"given":"Anna","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Hope","family":"Weissler","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn M","family":"Coleman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080604202600000_19.8.e266584.1","doi-asserted-by":"crossref","first-page":"151124","DOI":"10.1016\/j.sempedsurg.2021.151124","article-title":"Midaortic syndrome and renovascular hypertension","volume":"30","author":"Durgin","year":"2021","journal-title":"Semin Pediatr Surg"},{"key":"2026080604202600000_19.8.e266584.2","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.avsg.2019.12.039","article-title":"Clinical Characteristics and Long-Term Outcomes of Midaortic Syndrome","volume":"66","author":"Patel","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"2026080604202600000_19.8.e266584.3","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpu296"},{"key":"2026080604202600000_19.8.e266584.4","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1161\/HYPERTENSIONAHA.117.10296","article-title":"Whole Exome Sequencing Reveals a Monogenic Cause of Disease in \u224843% of 35 Families With Midaortic Syndrome","volume":"71","author":"Warejko","year":"2018","journal-title":"Hypertension"},{"key":"2026080604202600000_19.8.e266584.5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(81)90273-7"},{"key":"2026080604202600000_19.8.e266584.6","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13226778","article-title":"Renal Artery Stenosis and Mid-Aortic Syndrome in Children-A Review","volume":"13","author":"Pytlos","year":"2024","journal-title":"J Clin Med"},{"key":"2026080604202600000_19.8.e266584.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-013-2514-8"},{"key":"2026080604202600000_19.8.e266584.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-0767-4"},{"key":"2026080604202600000_19.8.e266584.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.10.047"},{"key":"2026080604202600000_19.8.e266584.10","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-1904","article-title":"Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents","volume":"140","author":"Flynn","year":"2017","journal-title":"Pediatrics"},{"key":"2026080604202600000_19.8.e266584.11","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1007\/s00467-018-4092-2","article-title":"Hypertensive crisis in children and adolescents","volume":"34","author":"Seeman","year":"2019","journal-title":"Pediatr Nephrol"},{"key":"2026080604202600000_19.8.e266584.12","first-page":"899","article-title":"The anatomy of the posterior wall of the abdominal aorta. 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