Chronic Aortic Dissection with Aorta-Right Atrium Fistula
10.4326/jjcvs.43.296
- VernacularTitle:大動脈-右心房交通をきたした慢性大動脈解離破裂の1例
- Author:
Mau Amako
;
Satoru Tobinaga
;
Yusuke Shintani
;
Yukio Hosokawa
;
Eiji Nakamura
;
Hiroyuki Ohtsuka
;
Koji Akasu
;
Seiji Onitsuka
;
Shinichi Hiromatsu
;
Hidetoshi Akashi
- Publication Type:Journal Article
- Keywords:
aortic dissection;
aorta-right atrium fistula;
transesophageal echocardiography
- From:Japanese Journal of Cardiovascular Surgery
2014;43(5):296-299
- CountryJapan
- Language:Japanese
-
Abstract:
Aortic dissection with rupture into the right atrium is an extremely rare and rapidly fatal condition. We report the case of a 59-year-old man with a history of double valve replacement 2 years earlier at another hospital. Although the previous postoperative course had been uneventful, the patient had experienced facial edema and general fatigue for 10 days before admission to our hospital because of heart failure. The diagnosis of chronic aortic dissection with rupture into the right atrium was confirmed by intraoperative transesophageal echocardiography. At operation, we observed an aortic dissection that originated from a tear in the original aortic incision line. The fistula extended from the false lumen to the right atrium. The aortic adventitia were partially defective. The aortic dissection had ruptured and a pseudo-aneurysm had formed. We performed ascending aortic replacement and closure of the aorta-right atrium fistula under hypothermic arrest on cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day.
