Pseudoaneurysms of the ascending aorta following coronary artery bypass surgery
| Autor: | Sunil Abrol, Joseph N. Cunningham, Ajay K. Dhadwal, Z. Zisbrod |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Transesophageal echocardiogram Chest pain law.invention Diagnosis Differential Pseudoaneurysm Coronary artery bypass surgery Postoperative Complications law medicine.artery Ascending aorta medicine Cardiopulmonary bypass Humans Fever of unknown origin Coronary Artery Bypass Aged Retrospective Studies medicine.diagnostic_test Aortic Aneurysm Thoracic business.industry Middle Aged medicine.disease Surgery Survival Rate Catheter cardiovascular system Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Aneurysm False Echocardiography Transesophageal Magnetic Resonance Angiography Follow-Up Studies |
| Zdroj: | Journal of cardiac surgery. 21(3) |
| ISSN: | 0886-0440 |
| Popis: | Background: Ascending aortic pseudoaneurysms following prior cardiac procedures are a rare entity. We reviewed our institutional experience given the isolated case reports in the literature. Methods: A 10-year retrospective review identified 5 patients who underwent ascending aorta pseudoaneurysm repair. There were 3 women and 2 men with a median age of 70 years (range 63 to 79 years). Median duration from initial CABG to pseudoaneurysm repair was 5 years (range 5 months to 18 years). The clinical presentations included dyspnoea (2 patients), chest pain, fever of unknown origin, and a pulsatile mass. Four patients underwent urgent investigation and surgery. Diagnosis was established via CT scan (3 patients), transesophageal echocardiogram (1 patient), and MRA (1 patient). Two patients had a prior history of sternal wound infection. Results: Mortality was 60%. One survivor experienced a stroke. The etiology was prior cannulation site in 4 cases and vein graft anastamotic site in 1. Necrotic aortic tissue was noticed in 2 cases. Aortic tissue cultures were negative in all the patients. Cardiopulmonary bypass was established prior to sternotomy in 4 cases and 1 case was performed off-pump. Inadvertent rupture of the pseudoaneurysm (without exsanguination) occurred in 2 cases following sternotomy. Repair was performed with bovine pericardial patch in 2 cases and plication in 3 cases. Conclusion: This highlights the varied presentation, necessity for urgent diagnosis and repair with a high operative mortality due to the late presentation. Aggressive diagnosis should be sought and consideration should be given to catheter-based interventions for initial treatment. |
| Databáze: | OpenAIRE |
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