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Thomassen SA, Leonaviciute D, Haahr PE, Frøkjær JB, Rasmussen BS. Keep Ventilating the Lungs While the Heart is Still Ejecting on Femoro-femoral Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth 2017; 32:1848-1850. [PMID: 29174662 DOI: 10.1053/j.jvca.2017.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Indexed: 11/11/2022]
Abstract
Femoro-femoral cardiopulmonary bypass (CPB) followed by deep hypothermic circulatory arrest is one of the modalities used for ascending aortic pseudoaneurysm repair to achieve cardiac unloading and to avoid severe hemorrhage due to the risk of rupture during the sternal entry. However, due to the limited size of the cannulas, it can be challenging to achieve total cardiopulmonary support. Therefore, despite the achievement of total cardiopulmonary support, the heart may still be able to eject antegrade blood flow that meets the retrograde blood flow from the arterial side of the CPB. The point where the blood flow meets in the aorta is called the watershed area. If the antegrade blood flow is large due to a left ventricular ejection, the watershed area will be located in the descending aorta. Therefore, if ventilation is stopped, deoxygenated blood will be ejected to the cerebral circulation. Cerebral near-infrared spectroscopy (NIRS) may be used as a noninvasive and continuous measurement of regional brain oxygen saturation (rSO2). This case demonstrates that cerebral desaturation due to discontinued mechanical ventilation, when the heart was still ejecting during the initial phase of femoro-femoral CPB, immediately was detected by a pronounced drop bilaterally: In the left frontal lobe, rSO2 fell from 56% to 21%, and in the right frontal lobe it fell from 47% to 25%. The authors recommend monitoring cerebral saturation using NIRS in the case of femoro-femoral CPB.
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Affiliation(s)
- Sisse Anette Thomassen
- Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Dovile Leonaviciute
- Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Poul Erik Haahr
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Bodil Steen Rasmussen
- Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Henley MD, Farber MA, Ikonomidis JS, Kolarczyk LM, Teeter EG, Barrick BP, Caranasos TG, Martinelli SM. A Tale of Three Surgeries: Management of a Massive Recurrent Mycotic Aortic Pseudoaneurysm. J Cardiothorac Vasc Anesth 2017; 32:550-557. [PMID: 29126684 DOI: 10.1053/j.jvca.2017.08.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Megan D Henley
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Mark A Farber
- Department of Surgery, Division of Vascular Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - John S Ikonomidis
- Department of Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lavinia M Kolarczyk
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily G Teeter
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian P Barrick
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Thomas G Caranasos
- Department of Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Susan M Martinelli
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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53
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Fallatah R, Elasfar AA, Alzubaidi S, Alraddadi M, Abuelatta R. Endovascular repair of a leaking aortic-arch pseudoaneurysm using graft stent combined with chimney protection to left common carotid artery: Case report and review of literature. J Saudi Heart Assoc 2017; 30:254-259. [PMID: 29983500 PMCID: PMC6026385 DOI: 10.1016/j.jsha.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 10/13/2017] [Indexed: 11/17/2022] Open
Abstract
Aortic pseudoaneurysm (PsA) is a rare but serious condition that has high mortality and morbidity rates if untreated. We report a rare case of leaking aortic-arch PsA repaired by thoracic endovascular aortic repair using graft stent with the chimney technique to protect the left common carotid artery. Unlike other cases in the literature, our case was unique, having leaking PsA not related to previous cardiac surgery or aortic dissection. The successful management of this patient using thoracic endovascular aortic repair combined with the chimney technique suggests that this approach may be an attractive therapeutic alternative to treat aortic-arch PsA.
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Affiliation(s)
- Raneem Fallatah
- Madina Cardiac Center, Madina, Saudi Arabia
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdelfatah A. Elasfar
- Madina Cardiac Center, Madina, Saudi Arabia
- Cardiology Department, Tanta University, Egypt
- Corresponding author at: Madina Cardiac Center, Madina, Saudi Arabia.
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54
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Darmoch F, Moussa Pacha H, Pagadala P, Alraies MC. Pseudoaneurysm of the ascending thoracic aorta years after aortic valve replacement. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2017; 19:196-198. [PMID: 28988707 DOI: 10.1016/j.carrev.2017.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 11/16/2022]
Abstract
Aortic pseudoaneurysm (PSA) formation post aortic valve replacement is one of the rare and devastating complications if left untreated. Aortic PSA can occur few weeks or month after surgery. The spectrum of symptoms varies from dyspnea, wide pulse pressure, and chest pain. However, in rare cases, aortic root PSA could be asymptomatic. Aortic PSA mortality could be as high as 70%, if left untreated. Therefore, High clinical suspicion and prompt surgical intervention is imperative. In this case, the patient presented with dyspnea years after Bentall procedure, and imaging studies revealed para-aortic PSA that was treated surgically.
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Affiliation(s)
- Fahed Darmoch
- Department of Internal Medicine, St Vincent Charity Medical Center, Cleveland, OH, USA
| | - Homam Moussa Pacha
- Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Prathyusha Pagadala
- Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - M Chadi Alraies
- MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC, USA.
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55
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Hanák V, Šantavý P. Acute myocardial infarction as the manifestation of the thoracic aorta pseudoaneurysm. COR ET VASA 2017. [DOI: 10.1016/j.crvasa.2016.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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56
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Seudoaneurisma poscirugía de Bentall: una enfermedad desafiante. CIRUGIA CARDIOVASCULAR 2017. [DOI: 10.1016/j.circv.2016.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Techniques for repair of the aorta currently include open and endovascular methods, hybrid approaches, minimally-invasive techniques, and aortic branch vessel reimplantation or bypass. Collaboration among radiologists and vascular and cardiothoracic surgeons is essential. An awareness of the various surgical techniques, expected postoperative appearance, and potential complications is essential for radiologists. This review will cover the postoperative appearance of the thoracic aorta with a focus on the ascending aorta. The value of three-dimensional image evaluation will also be emphasized.
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58
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Characteristics and outcomes of patients with postoperative cardiovascular pseudoaneurysms. J Thorac Cardiovasc Surg 2017; 153:43-50. [DOI: 10.1016/j.jtcvs.2016.08.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/18/2016] [Accepted: 08/30/2016] [Indexed: 11/23/2022]
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59
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Endovascular therapy for ascending aorta pseudoaneurysm. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2016; 17:586-588. [DOI: 10.1016/j.carrev.2016.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/21/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
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60
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Robotic-Assisted Coil Embolization of Ascending Aortic Pseudoaneurysm. Ann Thorac Surg 2016; 102:e451-e453. [DOI: 10.1016/j.athoracsur.2016.03.085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/17/2016] [Accepted: 03/28/2016] [Indexed: 11/21/2022]
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Yavuz Balci A, Vural U, Aksoy R, Özdemir MF, Satilmiş S, Kizilay M, Şenocak M, Şaşkin H, Kayacioğlu I, Yekeler I. The effect of proximal anastomosis on the expansion rate of a dilated ascending aorta in coronary artery bypass surgery: a prospective study. Cardiovasc J Afr 2016; 28:118-124. [PMID: 27701487 PMCID: PMC5545753 DOI: 10.5830/cvja-2016-071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 07/10/2016] [Indexed: 11/07/2022] Open
Abstract
Background: This study was designed to determine the short- and long-term effects of proximal aortic anastomosis, performed during isolated coronary artery bypass grafting (CABG) in patients with dilatation of the ascending aorta who did not require surgical intervention. Methods: The study was performed on 192 (38 female and 160 male patients; mean age, 62.1 ± 9.2 years; range, 42–80 years) patients with dilatation of the ascending aorta who underwent CABG surgery between 1 June 2006 and 31 May 2014. In group 1 (n = 114), the saphenous vein and left internal mammarian artery grafts were used, and proximal anastomosis was performed on the ascending aorta. In group 2 (n = 78), left and right internal mammarian artery grafts were used, and proximal aortic anastomosis was not performed. Pre-operatively and in the first and third years postoperatively, the ascending aortic diameter was measured and recorded using transthoracic echocardiography at four different regions (annulus, sinus of Valsalva, sinotubular junction and tubular aorta). Results: A statistically significant difference was found between the groups for the number of grafts used and the duration of aortic cross-clamping and cardiopulmonary bypass. No significant intergroup difference was seen for the mean diameter of the ascending aorta (p > 0.05). Annual changes in the aortic diameter were found to be extremely significantly different in both groups (p = 0.0001). Mean values of the aortic diameter at the level of the sinotubular junction and tubular ascending aorta, mean aortic diameters (p = 0.002 and p = 0.0001, respectively), annual increase in diameter (p = 0.0001 and p = 0.0001, respectively), and mean annual difference in diameter (p = 0.0001 and p = 0.0001, respectively) at one and three years postoperatively were statistically significantly different between the groups. Conclusion: In patients with ascending aortic dilatation who did not require surgical intervention and who had proximal anastomosis of the ascending aorta and underwent only CABG, we detected statistically significant increases in the diameter of the sinotubular junction and tubular aorta up to three years postoperatively.
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Affiliation(s)
- Ahmet Yavuz Balci
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
| | - Unsal Vural
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey.
| | - Rezan Aksoy
- Department of Cardiovascular Surgery, Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - M Fatih Özdemir
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
| | - Seçkin Satilmiş
- Department of Cardiology, Acibadem University, Istanbul, Turkey
| | - Mehmet Kizilay
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
| | - Mutlu Şenocak
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
| | - Huseyin Şaşkin
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, Istanbul, Turkey
| | - Ilyas Kayacioğlu
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
| | - Ibrahim Yekeler
- Department of Cardiovascular Surgery, Dr Siyami Ersek Cardiovascular Surgery and Thoracic Hospital, Istanbul, Turkey
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62
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Shiraev TP, Kwok TM, Rajendran S, Gan JP, Qasabian RA. Pseudoaneurysm of the thoracic aorta following botulinum toxin injection to the esophagus. J Vasc Surg Cases Innov Tech 2016; 2:126-129. [PMID: 38827205 PMCID: PMC11140365 DOI: 10.1016/j.jvscit.2016.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/30/2016] [Indexed: 11/19/2022] Open
Abstract
Aortic pseudoaneurysms are uncommon and are usually secondary to penetrating trauma. We describe the presentation and management of an elderly woman who suffered a pseudoaneurysm of the descending thoracic aorta several days after receiving botulinum toxin injection to the esophagus. Urgent thoracic endovascular aortic repair was performed, and long-term antibiotic therapy was commenced. Despite a slow initial clinical recovery, she returned to an independent lifestyle, with radiographic resolution of the pseudoaneurysm seen at follow-up. This case illustrates that endovascular aortic repair is a suitable and safe treatment option for this unusual presentation.
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Affiliation(s)
- Timothy P. Shiraev
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Trevor M.Y. Kwok
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Saissan Rajendran
- Department of Vascular Surgery, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - John P. Gan
- Department of Vascular Surgery, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Raffi A. Qasabian
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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63
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Aggarwal A, Banga S, Mungee S. Ascending Aortic Pseudoaneurysm: Sleeping Giant Arises in 3rd Decade after Surgery. Tex Heart Inst J 2016; 43:374-5. [PMID: 27547158 DOI: 10.14503/thij-14-4875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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64
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Oh KT, Derose J, Taub C. Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm. BMJ Case Rep 2016; 2016:bcr-2016-216320. [PMID: 27530875 DOI: 10.1136/bcr-2016-216320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication following aortic root replacement. This complication often takes place in the setting of acute graft infection and accompanies symptoms of heart failure, valve insufficiency or sepsis. We present a delayed, asymptomatic presentation of this complication in a young man with distant history of aortic root replacement and medically treated prosthetic valve endocarditis a year postoperatively. He had been non-adherent to warfarin over 10 years, but otherwise maintained a healthy life. After being lost to follow-up, he re-presented 12 years after the initial operation with new-onset seizures. Echocardiogram revealed complete dehiscence of a composite valved conduit at the proximal anastomosis site with a resultant large pseudoaneurysm. The patient underwent an urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit. He had an uncomplicated postoperative recovery and promised close follow-up on discharge.
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Affiliation(s)
- Kyung Taek Oh
- Montefiore Hospital and Medical Center, Bronx, New York, USA
| | - Joseph Derose
- Montefiore Hospital and Medical Center, Bronx, New York, USA
| | - Cynthia Taub
- Montefiore Hospital and Medical Center, Bronx, New York, USA
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65
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Kim HJ, Lee SM, Sung K, Kang IS, Lee JH, Min JJ, Kim E, Park J, Park JH. Transesophageal echocardiographic guidance for percutaneous closure of aortic pseudoaneurysm using a type II Amplatzer vascular plug: a case report. Korean J Anesthesiol 2016; 69:400-5. [PMID: 27482320 PMCID: PMC4967638 DOI: 10.4097/kjae.2016.69.4.400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 11/12/2022] Open
Abstract
Aortic pseudoaneurysm after cardiac surgery is a rare entity, but it is potentially fatal due to its clinical course along with higher morbidity and mortality rates. Instead of open surgical repair, percutaneous procedures have been introduced as other options for managing an aortic pseudoaneurysm. In this case report, we describe transesophageal echocardiography guidance for successful percutaneous closure of an aortic pseudoaneurysm located in the left ventricular outflow tract by using a type II Amplatzer vascular plug in a patient in whom open surgical repair was not recommended.
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Affiliation(s)
- Hyo Jin Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sangmin Maria Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kiick Sung
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Jin Min
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eunhee Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiyeon Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hyoung Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
BACKGROUND Pseudoaneurysm of the aortic arch is uncommonly associated with cancer, and is extremely rare in pulmonary cancer. Here, we report an unusual and successfully treated case of aortic arch pseudoaneurysm in a male patient with lung squamous cell carcinoma. METHODS A 64-year-old male patient was admitted to the Emergency Department, presenting with massive hemoptysis (>500 mL blood during the 12 hours prior to treatment). The diagnosis of aortic arch pseudoaneurysm was confirmed after inspection of computed tomographic angiography and three-dimensional reconstruction. We processed the immediate endovascular stent-grafting for this patient. RESULTS This patient recovered with no filling or enlargement of the pseudoaneurysm, no episodes of hemoptysis, and no neurological complications during the 4-week follow-up period. CONCLUSION Herein, we compare our case with other cancer-related pseudoaneurysms in the medical literature and summarize the clinical features and treatment of this unusual case.
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Affiliation(s)
- Yuan-Qiang Lu
- Department of Emergency Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
- Correspondence: Yuan-Qiang Lu, Department of Emergency Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, People's Republic of China (e-mail: or )
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67
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Karangelis D, Raju S, Dimarakis I, Roubelakis A, Fragoulis S. Treatment of a pseudoaneurysm of the ascending aorta in association with aortopulmonary fistula following acute Type A dissection. Perfusion 2016; 32:84-86. [PMID: 27440801 DOI: 10.1177/0267659116660186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This report describes a rare case of aortic pseudoaneurysm with an aortopulmonary fistula in a 69-year-old woman two years following repair of a Type A aortic dissection. The patient presented with NYHA Class IV symptoms having deteriorated rapidly over a course of six weeks. We describe our successful surgical repair following a failed attempt of percutaneous closure with an atrial septal occlusion device.
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Affiliation(s)
| | - Sneha Raju
- 2 Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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68
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Reparación de seudoaneurisma posquirúrgico de aorta ascendente complicado con rotura inminente y hemoptisis severa. CIRUGIA CARDIOVASCULAR 2016. [DOI: 10.1016/j.circv.2015.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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69
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Chevalier AT, Khaja MS, Yang B. Surgical Management of Necrotizing Mediastinitis With Large Aortic Pseudoaneurysm. Ann Thorac Surg 2016; 101:e143-5. [DOI: 10.1016/j.athoracsur.2015.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/18/2015] [Accepted: 10/09/2015] [Indexed: 11/27/2022]
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70
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Wakefield BJ, Winter D, Alfirevic A. Staged Repair of an Aortopulmonary Fistula From a Large Ascending Aortic Pseudoaneurysm: The Role of Transesophageal Echocardiography. J Cardiothorac Vasc Anesth 2016; 30:1329-33. [PMID: 27041238 DOI: 10.1053/j.jvca.2015.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Indexed: 11/11/2022]
Affiliation(s)
| | - Daniel Winter
- Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, OH
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71
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Qadri YJ, Kumar PA, Lateef B, Arora H. An Unusual Presentation of a Mediastinal Mass. J Cardiothorac Vasc Anesth 2016; 30:269-72. [DOI: 10.1053/j.jvca.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Indexed: 11/11/2022]
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72
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Wang W, Liu X, Lu M. Case-report: endovascular treatment of aortic pseudo-aneurysm caused by Fishbone. J Cardiothorac Surg 2015; 10:94. [PMID: 26152238 PMCID: PMC4494703 DOI: 10.1186/s13019-015-0304-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 06/29/2015] [Indexed: 01/08/2023] Open
Abstract
Aortic pseudo-aneurysm (APA) is a rare disease in clinic. Because of its relative rarity, we are far from making any conclusion regarding the natural history and appropriate therapeutic strategy for this condition. This study is to investigate the treatment effect of interventional therapy in aortic pseudo-aneurysm. A woman of 68 years old diagnosed with APA caused by fishbone was treated with stent grafts. After treatment, the therapeutic effect was assessed by measuring the size of trauma. The patient recovered well after stent grafts treatment, as her trauma was minimal. However, some complications of intravascular interventional treatment were observed. Compared with conventional surgery, interventional therapy of intravascular stent grafts has its merits. Therefore, this strategy was worthy to apply in the treatment of aortic pseudo-aneurysm.
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Affiliation(s)
- Wei Wang
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
| | - Xuesong Liu
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
| | - Mingjun Lu
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, No.151 Yanjiang West Road, Guangzhou, 510120, China.
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73
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Kar P, Gopinath R, Padmaja D, Kumar RV. Complex pseudoaneurysm of ascending aorta: Unusual cause of right heart dysfunction-implications to the anesthesiologist. J Anaesthesiol Clin Pharmacol 2015; 31:246-9. [PMID: 25948912 PMCID: PMC4411845 DOI: 10.4103/0970-9185.155159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pseudoaneurysm of ascending aorta (PAA) is a rare complication occurring after cardiac surgery. Because of rarity of the condition, most standard teaching and anesthetic literature do not highlight on these postoperative aortic complications. Right heart dysfunction associated with PAA is scarcely reported. We describe here two cases of PAA with right heart involvement and discuss the possible anesthetic challenges.
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Affiliation(s)
- Prachi Kar
- Department of Anaesthesia and Intensive Care, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
| | - Ramachandran Gopinath
- Department of Anaesthesia and Intensive Care, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
| | - Durga Padmaja
- Department of Anaesthesia and Intensive Care, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
| | - R V Kumar
- Department of CTVS, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
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74
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Belov IV, Komarov RN, Frolov KB, Salagaev GI. [Surgical treatment of patient with thoracoabdominal aorta rupture and large false aneurysm]. Khirurgiia (Mosk) 2015:63-64. [PMID: 25909555 DOI: 10.17116/hirurgia2015163-64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Iu V Belov
- Klinika aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova
| | - R N Komarov
- Klinika aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova
| | - K B Frolov
- Klinika aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova
| | - G I Salagaev
- Klinika aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova
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75
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Yamane Y, Mukai S, Morimoto H, Okubo S. Ascending aortic false aneurysm formation associated with rupture of acute type a aortic dissection. Ann Vasc Dis 2015; 8:49-51. [PMID: 25848434 DOI: 10.3400/avd.cr.14-00122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 12/18/2014] [Indexed: 11/13/2022] Open
Abstract
A 63-year-old man with ruptured acute type A aortic dissection was referred to our hospital. Computed tomography showed a false aneurysm arising from the false lumen located beside the ascending aorta. His hemodynamic status was stable inspite of the ruptured acute aortic dissection. We consider that the containment of the false aneurysm by thin mediastinal structures prevented worsening of his hemodynamic status, and this is extremely rare.
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Affiliation(s)
- Yoshitaka Yamane
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Shuhei Okubo
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
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76
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Agarwal C, Goel S, Jacobi A, Fernandes V, Sanz J. Cardiac MRI of a contained ascending aortic rupture extending into the pericardium. Eur Heart J Cardiovasc Imaging 2014; 16:457. [DOI: 10.1093/ehjci/jeu279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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77
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Takahashi M, Kondo T, Morichika M, Nakagawa K, Kuse A, Asano M, Ueno Y. An autopsy case of a ruptured pseudoaneurysm of the ascending aorta complicated by previous cardiac surgery for ventricular septal defect. Leg Med (Tokyo) 2014; 16:293-6. [DOI: 10.1016/j.legalmed.2014.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/01/2014] [Accepted: 05/03/2014] [Indexed: 10/25/2022]
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78
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Barik R, Patnaik AN, Kumar RV, Mohapatra RP, Medep V, Nemani L. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta. Ann Pediatr Cardiol 2014; 7:135-7. [PMID: 24987261 PMCID: PMC4070204 DOI: 10.4103/0974-2069.132490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA).
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Affiliation(s)
- Ramachandra Barik
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Amar Narayana Patnaik
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Ravintula Venkata Kumar
- Department of Cardiothoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Rudra Prasad Mohapatra
- Department of Cardiothoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Vikas Medep
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Lalita Nemani
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
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79
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Danzi GB, Succio G, Bocchiardo M, Nicolino A, Olivotti L, Moshiri S. Comprehensive definition of a giant ascending aortic pseudoaneurysm. QJM 2014; 107:591-2. [PMID: 24300163 DOI: 10.1093/qjmed/hct241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G B Danzi
- Emergency Department, Ospedale Santa Corona, Pietra Ligure, Italy
| | - G Succio
- Department of Radiology, Ospedale Santa Corona, Pietra Ligure, Italy
| | - M Bocchiardo
- Emergency Department, Ospedale Santa Corona, Pietra Ligure, Italy
| | - A Nicolino
- Emergency Department, Ospedale Santa Corona, Pietra Ligure, Italy
| | - L Olivotti
- Emergency Department, Ospedale Santa Corona, Pietra Ligure, Italy
| | - S Moshiri
- Emergency Department, Ospedale Santa Corona, Pietra Ligure, Italy
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80
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Ikenaga S, Mikamo A, Kudo T, Kurazumi H, Suzuki R, Hamano K. Pseudoaneurysm of the ascending aorta 31 years after mitral valve replacement. Asian Cardiovasc Thorac Ann 2014; 22:332-4. [PMID: 24585911 DOI: 10.1177/0218492312469519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a rare case of an ascending aortic pseudoaneurysm 31 years after mitral valve replacement with a Björk-Shiley mechanical valve. The aneurysm presumably expanded gradually during the years following surgery. As the valve was functioning normally, it was left in situ while the ascending aorta was replaced. This report provides valuable information regarding the long-term nature of this patient's pseudoaneurysm, and the long-term durability of the Björk-Shiley spherical valve in the mitral position.
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Affiliation(s)
- Shigeru Ikenaga
- Department of Surgery and Clinical Science, Yamagchi University School of Medicine, Yamaguchi, Japan
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81
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Black A, Alexander JA, Reoma J, Caranasos T, Staples ED, Martin TD, Hess PT, Klodell C, Beaver T. Safe sternal reentry in patients with large thoracic aortic pseudoaneurysms. Ann Thorac Surg 2014; 97:705-7. [PMID: 24484818 DOI: 10.1016/j.athoracsur.2013.05.112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 05/02/2013] [Accepted: 05/15/2013] [Indexed: 11/26/2022]
Abstract
Sternal reentry for ascending aorta pseudoaneurysm repair presents a formidable challenge because of the risk of aneurysm rupture and hemorrhage. We describe two cases of large pseudoaneurysms at high risk for rupture during sternal reentry in which the chest was safely entered by use of an anterior sternal retraction technique. Several other methods for sternal reentry have been reported; however, the reliability and efficiency of the described technique make it the preferred method for sternal reentry for pseudoaneurysms at our institution.
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Affiliation(s)
- Ashley Black
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - James A Alexander
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Junewei Reoma
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Thomas Caranasos
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Edward D Staples
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Tomas D Martin
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Philip T Hess
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Charles Klodell
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Thomas Beaver
- Department of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida.
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82
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Iatrogenic aortic pseudoaneurysm: A forgotten complication. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2013.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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83
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Pseudoaneurisma iatrogénico da aorta ascendente: uma complicação esquecida. Rev Port Cardiol 2014; 33:113.e1-5. [DOI: 10.1016/j.repc.2013.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 07/28/2013] [Accepted: 09/07/2013] [Indexed: 11/17/2022] Open
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84
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Ip EWK, Bourke VC, Stacey MC, Begley P, Ritter JC. Hard to diagnose and potentially fatal: slow aortic erosion post spinal fusion. J Emerg Med 2013; 46:335-40. [PMID: 24268895 DOI: 10.1016/j.jemermed.2013.08.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 07/15/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Delayed aortic injuries are a rare, but well-recognized complication of spinal surgery. They are a result of slow erosion of osteosynthesis material into the aorta. Although this is a life-threatening complication, patients might present years later with nonspecific symptoms. OBJECTIVE A complex case of slow aortic injury after thoracic spinal surgery is presented, which highlights the challenges involved in diagnosis and treatment. CASE REPORT A 62-year-old man had a T6 vertebrectomy and T5-7 anterior spinal fusion for multiple myeloma 5 years earlier. Two years postoperatively, the patient developed intermittent hemoptysis that triggered several presentations to the emergency department and consecutive hospital admissions during a 3-year period. All investigations, including endoscopy, bronchoscopy, and repeated chest computed tomography (CT) scans, were unremarkable. Eventually, the patient presented with frank hemoptysis associated with severe left-sided chest pain. Urgent CT angiography revealed a pseudoaneurysm measuring 34 × 20 mm at the level of the vertebrectomy. The patient underwent emergency surgery and an endoluminal stent graft was successfully placed. The patient remains well after 6 months. CONCLUSIONS The close proximity of the aorta and spine entertains the risk of aortic injury associated with vertebral osteosynthesis. Long-term complications of slow aortic erosion are extremely difficult to diagnose. The presented patient suffered from an undetected bronchio-aortic fistula with consecutive pseudoaneurysm formation and rupture. Awareness of slow aortic erosion is important for correct diagnostic pathways and subsequent early diagnosis to ensure a positive outcome for the patient.
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Affiliation(s)
- Edmond W K Ip
- Department of Vascular and Endovascular Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Victor C Bourke
- Department of Vascular and Endovascular Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Michael C Stacey
- Department of Vascular and Endovascular Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Patrick Begley
- Emergency Department, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Jens C Ritter
- Department of Vascular and Endovascular Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia
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85
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86
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Preisman S, Shinfeld A, Raanani E. Safe approach for chest reentry in a patient with large pseudoaneurysm of ascending aorta facilitated by intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesth 2013; 28:709-13. [PMID: 24016687 DOI: 10.1053/j.jvca.2013.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Sergey Preisman
- Department of Anesthesiology and Intensive Care, Sheba Medical Center (affiliated with Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.
| | - Amihay Shinfeld
- Department of Cardiac Surgery, Sheba Medical Center (affiliated with Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel
| | - Ehud Raanani
- Department of Cardiac Surgery, Sheba Medical Center (affiliated with Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel
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87
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Giant pseudoaneurysm of the ascending aorta after valve replacement. Medical follow-up for 22 months without complication. Herz 2013; 39:279-81. [PMID: 23535830 DOI: 10.1007/s00059-013-3789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 02/23/2013] [Indexed: 10/27/2022]
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88
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Yeh YH, Lin YC, Tsai W, Chien DK. A huge aortic root pseudoaneurysm. J Emerg Med 2012; 44:488-9. [PMID: 23103070 DOI: 10.1016/j.jemermed.2012.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 02/26/2012] [Accepted: 08/19/2012] [Indexed: 11/27/2022]
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89
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MDCT evaluation of postoperative aortic root pseudoaneurysms: imaging pearls and pitfalls. AJR Am J Roentgenol 2012; 199:W84-90. [PMID: 22733935 DOI: 10.2214/ajr.11.7794] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Aortic root pseudoaneurysm is a rare but potentially lethal complication after cardiac surgery. The objective of this article is to review the CT appearance of postoperative aortic root pseudoaneurysms, with emphasis on imaging pearls and pitfalls. CONCLUSION The most common location for postoperative aortic root pseudoaneurysm is the graft anastomosis site. MDCT with ECG gating and multiplanar and 3D reconstruction can provide critical information for preoperative planning.
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90
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Park JY, Shin JK, Chung JW, Kim JS, Chee HK, Song MG. Short-term Outcomes of Aortic Wrapping for Mild to Moderate Ascending Aorta Dilatation in Patients Undergoing Cardiac Surgery. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2012; 45:148-54. [PMID: 22708081 PMCID: PMC3373969 DOI: 10.5090/kjtcs.2012.45.3.148] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 11/03/2011] [Accepted: 11/22/2011] [Indexed: 11/29/2022]
Abstract
Background The adequate management of mild to moderate dilatation of the ascending aorta during cardiac operations remains controversial. In this study, we present the short-term outcomes of 90 patients undergoing ascending aortic wrapping with a Dacron graft during other cardiac operations. Materials and Methods From March 2008 to January 2011, 90 consecutive patients underwent treatment for ascending aortic aneurysm using the external wrapping technique during the concomitant procedure. The study group consisted of 49 male and 41 female patients with a mean age of 58.7±13 years. The primary cardiac surgical procedures were coronary artery bypass grafting (CABG) in 3, aortic valve replacement in 2, and aortic valvuloplasty in 85 patients (isolated in 62 and combined with CABG or mitral valvuloplasty in 23). The ascending aorta diameter was measured using a computed tomography scan within 4 weeks after surgery, and was compared with the preoperative value. Results The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within a month after surgery from 46.4±4.3 mm to 33.0±3.5 mm (p<0.05). There was no early mortality or major surgical complication. During the mean follow-up period of 15.4±5.2 months, there was only one late death caused by septic multiorgan failure. Conclusion Dacron wrapping of the ascending aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of moderately dilated ascending aorta in selected patients.
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Affiliation(s)
- Ji Young Park
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Korea
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91
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Bibiloni Lage I, Benussi S, Verzini A, Alfieri O. Amplatzer device migration through the sternum: a rare complication of percutaneous treatment for an aortic pseudoaneurysm solved by 2 length-adjustable bovine pericardium conduits. J Thorac Cardiovasc Surg 2012; 144:e27-8. [PMID: 22698559 DOI: 10.1016/j.jtcvs.2012.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 04/16/2012] [Accepted: 05/15/2012] [Indexed: 11/27/2022]
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92
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Ogawa T, Toda K, Fujita T, Higashi M, Kobayashi J. Pseudoaneurysm at the cannulation site of the ascending aorta arising 8 days postoperatively: report of a case. Surg Today 2012; 43:566-8. [PMID: 22678660 DOI: 10.1007/s00595-012-0194-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 01/18/2012] [Indexed: 10/28/2022]
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93
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Raffa GM, Malvindi PG, Ornaghi D, Basciu A, Barbone A, Tarelli G, Settepani F. Postsurgical aortic false aneurysm: pathogenesis, clinical presentation and surgical strategy. J Cardiovasc Med (Hagerstown) 2012; 14:593-6. [PMID: 22499001 DOI: 10.2459/jcm.0b013e32835369f2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Postsurgical aortic false aneurysm occurs in less than 0.5% of all cardiac surgical cases and its management is a challenge in terms of preoperative evaluation and surgical approach. Although infections are well recognized as risk factors, technical aspects of a previous operation may have a role in pseudoaneurysm formation. The risk factors and clinical presentation of pseudoaneurysms and the surgical strategy are revisited in this article.
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Affiliation(s)
- Giuseppe M Raffa
- Cardiac Surgery Unit, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy.
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94
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Joyce DL, Singh SK, Mallidi HR, Dake MD. Endovascular Management of Pseudoaneurysm Formation in the Ascending Aorta Following Lung Transplantation. J Endovasc Ther 2012; 19:52-7. [DOI: 10.1583/11-3601.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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95
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Jung TE, Lee DH. Surgery for pseudoaneurysm of the ascending aorta under moderate hypothermia. J Cardiothorac Surg 2011; 6:125. [PMID: 21958950 PMCID: PMC3191372 DOI: 10.1186/1749-8090-6-125] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 09/30/2011] [Indexed: 11/16/2022] Open
Abstract
Pseudoaneurysm of the ascending aorta is a rare complication after cardiac surgery. Particularly, pseudoaneurysm due to postoperative infection in the ascending aorta requires surgical treatment with antibiotics. If a large sized pseudoaneurysm is located at the retrosternal space, then there is a very high risk of massive bleeding from rupture during performance of resternotomy. To avoid this risk, we performed femoro-femoral bypass under moderate hypothermia with transient circulatory arrest, and we report here on the successful result of this case.
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Affiliation(s)
- Tae-Eun Jung
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University, Daegu, Korea
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96
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Marcano L, Naranjo A, Diaz F, González A. Ascending aortic pseudoaneurysm after aortic valve replacement with root enlargement in a pediatric patient. Pediatr Cardiol 2011; 32:853-4. [PMID: 21512786 DOI: 10.1007/s00246-011-9996-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 04/01/2011] [Indexed: 11/27/2022]
Affiliation(s)
- Luis Marcano
- Department of Surgery, Cardiocentro Pediátrico William Soler, Havana, Cuba.
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97
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Agrifoglio M, Pontone G, Andreini D, Biglioli P, Cheema FH, Barili F. Conservative management of the pseudoaneurysms of ascending aortic graft. J Cardiovasc Med (Hagerstown) 2011; 12:586-8. [DOI: 10.2459/jcm.0b013e3283474e71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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98
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Navaravong L, Saab F, Cook JR, Peterman M, Flack J. Ascending aortic pseudoaneurysm, a ticking bomb after cardiac surgery. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2011; 12:177-180. [DOI: 10.1016/j.carrev.2010.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 02/01/2010] [Accepted: 02/11/2010] [Indexed: 11/29/2022]
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99
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Thoracic aorta pseudoaneurysm with hemopericardium: unusual presentation of warfarin overdose. J Occup Med Toxicol 2011; 6:12. [PMID: 21521519 PMCID: PMC3114796 DOI: 10.1186/1745-6673-6-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 04/26/2011] [Indexed: 11/10/2022] Open
Abstract
There have been few case reports which discuss a relationship between warfarin overdose and aortic pseudoaneurysm leakage. We report the case of a female receiving warfarin who presented with dsypnea. Her international normalized ratio was > 10. Chest radiograph revealed cardiomegaly, and chest computed tomography (CT) showed a bulging pouch-like lesion below the aortic arch greater than 6x6 cm in size and a fluid collection suggesting blood in the pericardium. Thoracic endovascular aneurysm repair (TEVAR) was successfully performed by a cardiovascular surgeon. Aortic pseudoaneurysm formation and leakage may be considered as a rare complication in patients receiving warfarin therapy. Further study regarding warfarin use and the incidence of pseudoaneurysm leakage is needed.
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100
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Vaughan-Huxley E, Hamady M, Metcalfe M, Adams B, Kashef E, Cheshire N, Bicknell C. Endovascular Repair of an Acute, Mycotic, Ascending Aortic Pseudoaneurysm. Eur J Vasc Endovasc Surg 2011; 41:488-91. [DOI: 10.1016/j.ejvs.2010.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 12/13/2010] [Indexed: 11/15/2022]
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