A Case of Giant Pseudoaneurysm Following Island-Fashion Arch Reconstruction
10.4326/jjcvs.44.232
- VernacularTitle:島状再建による全弓部置換術後11年目に巨大な弓部吻合部仮性動脈瘤をきたし再手術を施行した1例
- Author:
Ryohei Matsuura
;
Yasushi Tsutsumi
;
Osamu Monta
;
Hisazumi Uenaka
;
Satoshi Taniguchi
;
Kenji Tanaka
;
Takaaki Samura
;
Hirokazu Ohashi
- Publication Type:Journal Article
- Keywords:
island reconstruction;
pseudoaneurysm;
arch replacement
- From:Japanese Journal of Cardiovascular Surgery
2015;44(4):232-236
- CountryJapan
- Language:Japanese
-
Abstract:
We report the rare case of a 68-year-old man, who was admitted to our hospital with a diagnosis of aortic arch anastomotic pseudoaneurysm, with concomintant aortic root enlargement and coronary artery stenosis. Eleven years previously, at age 56, he underwent total arch replacement with island reconstruction for chronic aortic dissection. We performed redo total arch replacement, aortic root replacement and coronary artery bypass, making use of a cardiopulmonary bypass with cannulation through the right subclavian artery, femoral artery and femoral vein before resternotomy. We also used selective cerebral perfusion. Postoperatively, the patient temporarily required reintubation ; however, he was discharged in good condition on the 50th post-operative day. The case suggests that island reconstruction has the potential to cause an aortic arch pseudoaneurysm, particularly after a long postoperative period of time. Therefore, thorough postoperative care strategy is required. We also need to consider surgical reconstructive techniques which eliminate vascular lesions as much as possible at the time of the primary surgery, particularly in cases of chronic aortic dissection.
