Pseudoaneurysm of the Ascending Aorta Combined with Aortic Valve Infective Endocarditis following Cardiac Operations

2011 ◽  
Vol 14 (1) ◽  
pp. 70
Author(s):  
Shengli Jiang ◽  
Tao Zhang ◽  
Bojun Li ◽  
Chonglei Rei ◽  
Tingting Chen ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Hypothermic Circulatory Arrest ◽  
Mechanical Prosthesis ◽  
Computed Tomographic ◽  
Life Threatening ◽  
Femorofemoral Bypass ◽  
Cardiac Operations

Background and Objective: Aortic pseudoaneurysms are rare but life-threatening complications of aortic procedures. Operation on the femorofemoral bypass with hypothermic circulatory arrest has been the method of choice. Iatrogenic ascending aorta pseudoaneurysm combined with infective endocarditis of the aortic valve has never been reported.Materials and Methods: We describe a case of a pseudoaneurysm of the ascending aorta at the site of an aortotomy site concomitant with infective endocarditis of the aortic valve. A contrast computed tomographic scan was the investigation technology of choice.Results: The operation was performed on femorofemoral bypass without hypothermic circulatory arrest, which provided safe re-entry and an opportunity to replace the infected aortic valve with a mechanical prosthesis and to repair the aortic defect with a patch.Conclusions: The ascending aorta pseudoaneurysm can be safely operated on with femorofemoral bypass without hypothermic cardiac arrest.

scholarly journals Pseudoaneurysm of Ascending Aorta with Sternal Erosion after Double Valve Replacement—A Case Report

2019 ◽  
Vol 04 (02) ◽  
pp. 092-094
Author(s):  
Ravi Kumar Kathi ◽  
Amaresh Rao Malempati ◽  
Goutham Kollapalli ◽  
Chaitra Krishna Batt ◽  
Sayyad Sohail Tarekh
Keyword(s):  
Rare Complication ◽  
Circulatory Arrest ◽  
Aortic Surgery ◽  
Muscle Flap ◽  
Ascending Aorta ◽  
Hypothermic Circulatory Arrest ◽  
Chronic Hypertension ◽  
Pulsatile Mass ◽  
Fatal Hemorrhage ◽  
Femorofemoral Bypass

AbstractPseudoaneurysm of ascending aorta is a rare complication after aortic surgery. Predisposing factors can be infection, chronic hypertension, connective tissue disorders, or dissection. Chest pain, sternal erosion, dysphagia, or stridor can be the modes of presentation. It can also present as a pulsatile mass. Redo sternotomy in a case of pseudoaneurysm of aorta can cause fatal hemorrhage or air embolism. In such a scenario, femorofemoral bypass and hypothermic circulatory arrest help to simplify the approach to the pseudoaneurysm. The authors present a case of a 23-year-old female with pseudoaneurysm of the ascending aorta causing sternal erosion. Ascending aortic repair was done using Dacron patch with femorofemoral bypass and hypothermic circulatory arrest. Sternum was repaired using pectoralis major muscle flap.

scholarly journals Diffuse Supravalvular Aortic Stenosis: Surgical Repair in Adulthood

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Giovanni Ferlan ◽  
Claudio De Pasquale ◽  
Concetta Losito ◽  
Annalisa Fiorella ◽  
Nicola Marraudino ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Three Dimensional ◽  
Ascending Aorta ◽  
Supravalvular Aortic Stenosis ◽  
Mechanical Prosthesis ◽  
Computed Tomographic ◽  
Valve Function ◽  
Normal Shape

We present the case of a 54-year-old woman in which a diffuse congenital supravalvular aortic stenosis (SVAS) was associated with a severe aortic valve incompetence and heavy calcification of the aortic annulus. Repair consisted in resection of the ascending aorta, patch augmentation of the hypoplastic aortic root and annulus, placement of a 20 mm Dacron tubular graft (Vascutek, Renfrewshire, UK) and aortic valve replacement with a mechanical prosthesis (Sorin, Turin, Italy). Follow-up echocardiography demonstrated normal prosthetic valve function and a postoperative three-dimensional computed tomographic scan showed a normal shape of the reconstructed ascending aorta.

scholarly journals Aortic Arch Replacement without Deep Hypothermic Circulatory Arrest

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Zviad Bakhutashvili ◽  
Lia Janelidze ◽  
Kakhaber Beria ◽  
Simon Matikashvili ◽  
Eduard Limonjiani
Keyword(s):  
Aortic Valve ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Artery Bypass ◽  
Deep Hypothermic Circulatory Arrest ◽  
Ascending Aorta ◽  
Hypothermic Circulatory Arrest ◽  
Moderate Hypothermia ◽  
Aortic Arch Replacement ◽  
Valve Insufficiency

A 60-year-old man presented with a thoracic aortic aneurysm without rupture accompanied by severe nonrheumatic aortic valve insufficiency and unstable angina. Surgery was performed and included several steps: (1) resection and reconstruction of ascending aorta and aortic arch using a tube graft, (2) replacement of aortic valve using a biological prosthesis, and (3) coronary artery bypass grafting was performed with two distal anastomoses. All of these procedures were performed with total cardiopulmonary bypass without deep hypothermic circulatory arrest under conditions of moderate hypothermia using dual concurrent cannulation of the subclavian and femoral arteries.

Outcomes of Aortic Valve and Concomitant Ascending Aorta Replacement Performed via a Minimally Invasive Right Thoracotomy Approach

2014 ◽  
Vol 9 (5) ◽  
pp. 339-342 ◽  
Author(s):  
Angelo LaPietra ◽  
Orlando Santana ◽  
Andrés M. Pineda ◽  
Christos G. Mihos ◽  
Joseph Lamelas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Aortic Valve ◽  
Minimally Invasive ◽  
Circulatory Arrest ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Hypothermic Circulatory Arrest ◽  
Left Ventricular Ejection ◽  
Lengths Of Stay

Objective Replacement of the aortic valve with concomitant replacement of the ascending aorta performed via a minimally invasive right anterior thoracotomy approach has not been reported. We evaluated the feasibility and safety of this procedure. Methods We retrospectively reviewed all minimally invasive aortic valve replacements (AVRs) with concomitant replacement of the ascending aorta performed at our institution between January 1, 2012, and December 30, 2012. The operative times, intensive care unit and hospital lengths of stay, postoperative outcomes, as well as mortality were analyzed. Results A total of 20 consecutive patients who underwent minimally invasive AVR with concomitant replacement of the ascending aorta were identified. There were 16 men (80%), with a mean (SD) age of 61 (13) years. The mean (SD) left ventricular ejection fraction was 58% (8%). The aortic valve was bicuspid in 18 patients (80%), with 14 (70%) being stenotic. The median aortic cross-clamp and cardiopulmonary bypass times were 163 [interquartile range (IQR), 141–170] minutes and 291 (IQR, 177–215) minutes, respectively. Hypothermic circulatory arrest was required in 19 patients (95%), with a median hypothermic circulatory arrest time of 35 (IQR, 33–39.5) minutes. The median intensive care unit and hospital lengths of stay were 24 (IQR, 23–41) hours and 5 (IQR, 4–6) days, respectively. There were no strokes, reoperations for bleeding, or conversions to sternotomy. The 30-day mortality was zero. Conclusions Minimally invasive AVR with concomitant replacement of the ascending aorta, via a right anterior thoracotomy approach, can be performed with low morbidity and mortality.

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