scholarly journals Giant Distal Anastomotic Pseudoaneurysm 35 Years after Bentall Operation Mimicking an “Elephant Trunk”

Aorta ◽  
2021 ◽  
Vol 09 (05) ◽  
pp. 193-195
Author(s):  
Raffaele Scaffa ◽  
Mario Torre ◽  
Antonio Longobardi ◽  
David Ferrara ◽  
Maria G. Vassallo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Suture Line ◽  
Elephant Trunk ◽  
Bentall Operation ◽  
Aortic Pseudoaneurysm ◽  
Bentall Procedure ◽  
Anastomotic Pseudoaneurysm ◽  
Elephant Trunk Procedure ◽  
Coronary Ostia

AbstractWe present the case of a giant distal aortic pseudoaneurysm 35 years after a classic mechanical Bentall operation. Computed tomography and coronary angiography showed that this originated from the distal suture line. The proximal suture and coronary ostia appeared to be intact. At reoperation, we found a complete dehiscence of distal suture line: the graft was floating in the pseudoaneurysm, mimicking an “elephant trunk” procedure. This complication suggested a systematic and accurate follow-up of patients who underwent an original Bentall procedure.

scholarly journals Simple endovascular thoracic aortic stenting rescues a wrongly deployed frozen elephant trunk during a modified procedure

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098671
Author(s):  
Gregory Reid ◽  
Constantin Mork ◽  
Edin Mujagic ◽  
Denis Berdajs
Keyword(s):  
Computed Tomography ◽  
Thoracic Aorta ◽  
Computed Tomography Angiography ◽  
False Lumen ◽  
Distal Segment ◽  
Type I ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Stenting ◽  
Elephant Trunk Procedure

We report a bail out approach of endovascular thoracic aorta repair following incorrect deployment of a modified frozen elephant trunk stent graft into the false lumen. A 76-year-old patient was admitted to our Emergency Department. A computed tomography angiography scan showed type I DeBakey aortic dissection. An emergency modified frozen elephant trunk procedure was performed. Immediate postoperative computed tomography angiography showed that the distal segment of the stent was deployed in the false lumen, probably through a re-entry tear at the descending thoracic aorta. Emergency endovascular repair of the thoracic aorta, as well as angioplasty of the superior mesenteric artery and left iliac artery, were performed.

scholarly journals A Case of Conservative Treatment of Postsurgical Aortic False Aneurysm

2017 ◽  
Vol 9 ◽  
Author(s):  
Fabrizio Follis ◽  
Giuseppe Maria Raffa ◽  
Giuseppe Montalbano ◽  
Giuseppe Mamone ◽  
Marco Follis
Keyword(s):  
Conservative Treatment ◽  
Suture Line ◽  
Acute Type ◽  
Mechanical Prosthesis ◽  
Bentall Operation ◽  
Acute Type A Dissection ◽  
Close Observation ◽  
Type A Dissection ◽  
And Control

<p>A 51-year-old male underwent replacement of the ascending aorta for acute type A dissection. The post-operative course was uncomplicated, and he was discharged home. Approximately a month later, control CT revealed an enlarging pseudoaneurysm of the proximal anastomosis. The patient was re-operated, and a Bentall operation with mechanical prosthesis was performed. Again, surgery was uncomplicated, but follow-up CT scan revealed a recurrent small pseudoaneurysm of the proximal suture line. He was managed with close observation, and control CT at four months showed complete resolution. Conservative treatment of small postsurgical pseudoaneurysms is discussed.   </p>

scholarly journals Infected Anastomotic Pseudoaneurysm after Aortic Valve Replacement with Annular Enlargement

2019 ◽  
Vol 22 (3) ◽  
pp. E252-E255
Author(s):  
Runqian Sui ◽  
Jie Zi ◽  
Liangong Sun ◽  
Decai Li ◽  
Anbiao Wang
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Ascending Aorta ◽  
Anastomotic Pseudoaneurysm ◽  
Computed Tomography Scans ◽  
Infected Pseudoaneurysm ◽  
Life Threatening ◽  
Important Means ◽  
Anastomotic Line

Anastomotic pseudoaneurysm remains one of the main life-threatening complications of cardiac and thoracic aorta surgery. We report a rare case of infected pseudoaneurysm at the anastomotic line found during follow-up. Blood culture results suggested Enterococcus faecium infection. Transthoracic echocardiography and computed tomography scans revealed the presence of a pseudoaneurysm of the ascending aorta. The pseudoaneurysm was resected and the ascending aorta was reconstructed with an artificial vascular patch without complications. Reducing the anastomotic tension, with complete hemostasis at the anastomotic incision, is the most important means of preventing the formation of pseudoaneurysm.

Impact of Modified Frozen Elephant Trunk Procedure on Downstream Aorta Remodeling in Acute Aortic Dissection: CT Scan Follow-Up

2020 ◽  
Vol 44 (5) ◽  
pp. 1648-1657
Author(s):  
Luca Koechlin ◽  
Josefin Kaufmann ◽  
Evelina Macius ◽  
Jens Bremerich ◽  
Gregor Sommer ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
Acute Aortic Dissection ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Elephant Trunk Procedure

scholarly journals Bentall procedure with the CarboSeal™ and CarboSeal Valsalva™ composite conduits: long-term outcomes

2021 ◽  
Author(s):  
Andrea Lechiancole ◽  
Igor Vendramin ◽  
Sandro Sponga ◽  
Daniela Piani ◽  
Giovanni Benedetti ◽  
...  
Keyword(s):  
Long Term Results ◽  
Long Term Outcomes ◽  
Mechanical Prosthesis ◽  
Actuarial Survival ◽  
Bentall Operation ◽  
Type A Aortic Dissection ◽  
Bentall Procedure ◽  
The Right

Abstract OBJECTIVES Data on the long-term results with the standard CarboSeal™ mechanical conduit used for the modified Bentall procedure are lacking as well as information on performance of the Valsalva CarboSeal™ conduit. METHODS We have analysed 208 recipients of a standard (n = 110) or a Valsalva (n = 98) CarboSeal™ conduit. The median age was 60 years and 90% were males; 35 (17%) had type A aortic dissection and 65 (30%) a bicuspid aortic valve. Data were retrospectively analysed and results were compared between the 2 conduit models. RESULTS Early mortality was 1.9%; the mean follow-up was 175 ± 95 for standard and 94 ± 51 months for Valsalva conduits (P &lt; 0.01). Actuarial survival was 86 ± 4%, 75 ± 6%, 59 ± 7% and 51 ± 9% at 5, 10, 15 and 20 years, respectively. There were 13 thromboembolic episodes with 3 deaths with an actuarial freedom of 98 ± 1%, 94 ± 2%, 90 ± 3% and 89 ± 4% at 5, 10, 15 and 20 years, respectively. Reoperation on the aortic root was performed in 9 patients for endocarditis (n = 8) and pseudoaneurysm at the right coronary button (n = 1) with an actuarial freedom of 97 ± 1%, 95 ± 2%, 92 ± 3% and 87 ± 4% at 5, 10, 15 and 20 years, respectively. There were no differences between the 2 conduit models in survival and major postoperative complications. CONCLUSIONS The CarboSeal™ conduit has shown gratifying overall performance up to 20 years and appears a valid option for a modified Bentall operation, when a mechanical prosthesis is indicated. Both CarboSeal™ conduit models provided not statistically different overall long-term results.

scholarly journals COMPLICATED COURSE OF LATE PATIENT’S SURVIVAL AFTER THE CLASSIC BENTALL PROCEDURE WITH THE CABROL SHUNT

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Aleksejus Zorinas ◽  
Donatas Austys ◽  
Vilius Janušauskas ◽  
Ignas Rakita ◽  
Rimantas Karalius ◽  
...  
Keyword(s):  
Right Heart Failure ◽  
Suture Line ◽  
Bentall Operation ◽  
Anastomotic Complications ◽  
Pseudoaneurysm Formation ◽  
Bentall Procedure ◽  
Coronary Pseudoaneurysm ◽  
Anastomotic Disruption ◽  
Complicated Course ◽  
The Right

In the setting of bleeding into the perigraft space, the classic Bentall operation can be modified by the usage of the Cabrol shunt. This shunt is applied in order to drain the blood into the right atrium and it is expected to close gradually. Anastomotic suture line disruption along with concomitant blood flow into the perigraft space may rarely open the shunt and cause the right heart failure. Due to the anastomotic complications, the classic Bentall operation no longer is widely used in clinical practice, but patients who underwent such procedure some decades ago may be coping with various symptoms nowadays. In this article, the cases of anastomotic disruption as well as pseudoaneurysm formation and the opening of the Cabrol shunt 21 years after such kind of operation are presented. The patient underwent surgical repair and was confronted with the reoccurrence of the coronary pseudoaneurysm three years later.

Frozen Elephant Trunk Technique to Treat Extensive Thoracic Aortic Mural Thrombus

2021 ◽  
Author(s):  
Dmitri S. Panfilov ◽  
Boris N. Kozlov
Keyword(s):  
Computed Tomography ◽  
Anticoagulation Therapy ◽  
Early Postoperative Period ◽  
Mural Thrombus ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Left Hand ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

AbstractWe describe a case report of a 63-year-old man who presented with chronic left-hand weakness and the absence of a pulse in the left arm. Thoracoabdominal computed tomography (CT) revealed an extensive thoracic aortic mural thrombus. Initial anticoagulation therapy did not provide a positive result, so the patient was referred for surgery. Hybrid aortic arch surgery using the frozen elephant trunk technique was performed with excellent early outcomes. A CT performed in the early postoperative period showed that the thrombus was completely excluded from the aortic lumen by the hybrid graft. No thrombus dislodgment was detected. No thrombus recurrence was observed during 19 months of follow-up.

An aorto-oesophageal fistula treated with total arch repair combined with oesophageal repair

2021 ◽  
Author(s):  
Chaojie Wang ◽  
Liming Lei ◽  
Wenqian Zhang ◽  
Xiaoping Fan
Keyword(s):  
Surgical Repair ◽  
Graft Infection ◽  
Severe Infection ◽  
Fish Bone ◽  
Elephant Trunk ◽  
Artificial Graft ◽  
Aortic Arch Repair ◽  
Elephant Trunk Procedure ◽  
The Right

Abstract Aorto-oesophageal fistula is a rare but fatal disease. Open surgical repair or endotube repair of aorta and oesophagus save patients from circulatory deterioration, major haematemesis and severe infection. Here we present a rare case of an aorto-oesophageal fistula in the right hemi-arch caused by a fish bone treated with an alternative surgical strategy. Total aortic arch repair using the frozen elephant trunk procedure combined with oesophageal repair were performed. No aortic fistula, oesophageal fistula or artificial graft infection occurred in the follow-up.

scholarly journals Repair of residual aortic dissections with frozen elephant trunk technique

2020 ◽  
Vol 28 (3) ◽  
pp. 419-425
Author(s):  
Mustafa Akbulut
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Aortic Replacement ◽  
Elephant Trunk Procedure

Background: In this study, we present our mid-term results of reoperation with the frozen elephant trunk procedure due to patent false lumen-related complications in patients previously undergoing supracoronary aortic repair for acute type A aortic dissection. Methods: Between January 2013 and September 2018, a total of 23 patients (17 males, 6 females; mean age 51.5±9.7 years; range, 30 to 67 years) who underwent ascending aortic replacement due to type A aortic dissection and, later, frozen elephant trunk procedure for residual distal dissection were included. For diagnostic purposes and follow-up, computed tomography angiography was performed in all patients, and both re-entry and aortic diameters were evaluated. Echocardiography was used to evaluate cardiac function and valve pathologies. Results: The Ishimaru zone 0 (n=11, 47.8%), Ishimaru zone 1 (n=1, 4.3%), Ishimaru zone 2 (n=4, 17.4%), and Ishimaru zone 3 (n=7, 30.4%) were used for frozen elephant trunk stent graft fixation. The mean duration of cardiopulmonary bypass and antegrade selective cerebral perfusion was 223.9±71.2 min and 88.9±60.3 min, respectively. In-hospital mortality was 13%, while there was one (4.3%) aortic-related death and four (17.4%) re-interventions during follow-up. Conclusion: Early repair should be considered in the presence of persistent dissections due to alarmingly high mortality rates of reoperations. Reoperation with the frozen elephant trunk procedure has acceptable results and the decision of the procedure to be performed should be based on preoperative risk factors of the patient.

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