Midaortic Syndrome and Renovascular Hypertension Program
Our innovative approach
Boston Children's Hospital's Midaortic Syndrome and Renovascular Hypertension (MAS/RVH) Program is one of the only centers of its kind devoted to diagnosing, treating and providing long-term care for pediatric patients with either or both of these rare disorders.
Why is it so important to see a pediatric specialist for MAS and/or RVH?
Not only are MAS and RVH rare and potentially life-threatening conditions; they can also affect different children in very different ways. It's essential to seek care from a team of pediatric specialists who are highly experienced in diagnosing and treating these conditions and all related complications.
How are MAS and RVH usually diagnosed?
Most children with midaortic syndrome and/or renovascular hypertension are diagnosed after being examined for signs of severe high blood pressure (hypertension).
The exact symptoms of MAS/RVH will depend on the individual child, but can include:
- vision changes
- abdominal pain that begins after a meal
- discomfort or weakness in the legs during exercise
- poor growth
Some of the tests our doctors may use to confirm that a child has MAS and/or RVH are:
- angiography—injection of a special dye into blood vessels, then using X-ray imaging to look for narrowing
- ultrasonography—a painless, non-invasive procedure that uses special sound waves to create pictures of a child's organs
- Computed Tomography (CT)
- Magnetic Resonance Imaging (MRI)
What are the standard treatment options for MAS and RVH?
The treatment approach for each child depends very much on:
- whether she has MAS, RVH or both
- which blood vessels are affected (and how extensively)
- her particular symptoms
- her age and overall health
Treatment options typically include one or more of the following:
- medication to control blood pressure and improve heart and/or kidney function
- angioplasty—the use of a narrow tube called a catheter to insert and inflate a balloon inside the narrowed artery, widening it and improving blood flow to the affected organs
stenting—the placement of a special tube called a stent in a narrowed artery to hold it open
In the most serious cases, doctors may recommend:
- bypass graft surgery—an operation that makes detours, or "bypasses," around narrowed arteries, creating new paths for blood to flow
- autotransplantation—moving a kidney to a new location where the blood flow can be improved
kidney transplantation (in cases where both kidneys are damaged to the point of causing irreversible kidney failure)
Boston Children's groundbreaking new treatment
In a very exciting development, Boston Children's Hospital has pioneered a novel way of "stretching" the healthy vessels in the aorta to make them long enough to adequately replace the narrowed vessels. This procedure is called Tissue Expander Stimulated Lengthening of Arteries (TESLA).