Disruption of a Dacron Graft Caused by the Vertebral Body of the Lumbar Vertebrae after Reconstruction of the Thoracoabdominal Aortic Aneurysm

VernacularTitle:胸腹部大動脈瘤術後に腰椎椎体前方に形成された骨棘により人工血管に穿孔を来した1例
Author: Kouan Orii ; Masafumi Hioki ; Yoshio Iedokoro ; Jiro Honda
Publication Type:Journal Article
Keywords: thoracoabdominal aortic aneurysm; lumbar vertebral body of vertebrae; osteophyte; disruption of dacron graft
From:Japanese Journal of Cardiovascular Surgery 2012;41(4):211-214
CountryJapan
Language:Japanese
Abstract: We report an extremely rare case of early disruption of a woven Dacron graft by the mechanical force of the lumbar vertebral body after a thoracoabdominal aortic aneurysm repair. A 75-year-old man with thoracoabdominal aortic aneurysm of Crawford type III underwent replacement of the thoracoabdominal aorta using a Gelweave thoracoabdominal graft (Vascutek) and a Gelweave bifurcate graft (Vascutek). His postoperative course was uneventful and discharged on postoperative day 20. On the 22nd postoperative day, he was re-hospitalized with low back pain. Computed tomography scanning showed a massive hematoma around the region of the graft-to-graft anastomosis. He underwent an emergency operation. At laparotomy, the Gelweave thoracoabdominal graft had a 2-mm hole which had been caused by the mechanical force of lumbar vertebral body, which was not related to the anastomosis. The graft was repaired with a 4-0 polypropylene buttress suture and a new prosthesis graft was used to wrap around the disrupted graft.