scholarly journals Aortic root aneurysm with right atrial clot: a rare combination

2021 ◽  
Author(s):  
Debmalya Saha ◽  
Kaushik Mukherjee ◽  
Amrita Guha
Keyword(s):  
Aortic Root ◽  
Liver Function Tests ◽  
Ascending Aorta ◽  
Right Atrial ◽  
Poor General Condition ◽  
Aortic Root Aneurysm ◽  
Bentall Procedure ◽  
Clot Removal ◽  
Preoperative Optimization ◽  
The Right

Though the incidence of aneurysms involving the aortic root and/or ascending aorta is common, the combination of aortic root aneurysm and the right atrial clot is extremely rare. No such case is reported in literature till date. This case report presents a 52-year gentleman who came to our emergency department with complaints of breathlessness, abdominal distention, pedal swelling, and decreased urine output with extremely poor general condition. After hemodynamic stabilization and preoperative optimization and workup, he was managed with Bentall procedure with right atrial clot removal. The immediate postoperative course was normal except for deranged liver function tests. The patient was discharged on postoperative day ten.

scholarly journals P692 Curious Bentall procedure complications, not always found in the immediate postoperative period

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Blasco Turrion ◽  
P Gonzalez Perez ◽  
J A Sanchez Brotons ◽  
A Gomez Lopez ◽  
F J Morales Ponce
Keyword(s):  
Coronary Artery ◽  
Postoperative Period ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Diagnostic Process ◽  
Prior History ◽  
Bentall Procedure ◽  
Aggressive Surgical Approach ◽  
Acute Dissection ◽  
The Right

Abstract Ascending aorta aneurisms are often diagnosed in patients around 60-70 years old with prior history of hypertension or smoking, or in younger patients with connective tissue illnesses, such as Marfan Syndrome (MS), or bicuspide aortic valve (BAV). In patients with MS an aneurysm of the aortic root, ascending aorta or acute dissection are the most frequent reasons of death, that is why an aggressive surgical approach is recommended, by repairing or replacing the diseased aortic root. Prophylactic aortic root surgery is an effective procedure in preventing acute dissection and rupture with excellent long-term outcomes as published in the literature, being the Bentall procedure usually the treatment of choice. However, the implantation of a mechanic aortic prosthesis makes permanent oral anticoagulation necessary with elevated haemorragic risk. We present two peculiar cases of Bentall procedure with differentes indications, different scenarios but similar outcomes. - Case A: A 75-year-old female with MS who underwent Bentall surgery in 1988 due to a severe AR, stable and asymptomatic since then. In a routine check-up in November 2017, a dilatation of 65mm in her native ascending aorta was detected on a computed tomography scan (CT), visualizing a half-moon shaped space between the ascending aorta and the aortic tube of 21x46mm and a leak from de aorto-ostial union, being possible to confirm with the TEE its origin in the left coronary ostium, which was also dilated (10mm), due to a dehiscence in the aortic tube suture on that level. - Case B: A 43-year-old male who underwent Bentall surgery in 2014 due to a severe AR and aortic root aneurysm that in January 2017 was admitted to our hospital due to chest pain with no other symptoms associated. As part of the study and TTE, TEE and CT were performed in which a periaortic haematoma from de aortic root to the beginning of the aortic arch was found, visualizing a leak from a 5mm hole in the ostium of the right coronary artery. In addition, the left coronary artery had a severe stenosis (85%) due to the compression of the haematoma on that level. Even though the Bentall procedure has excellent outcomes we discovered unusual either long and short-term complications due to dehiscence of the sutures, causing a huge peri-prosthetic tube haematoma, compressing the left main coronary artery in one of our patients which was the cause of the angina he presented with. We think these images could help the diagnostic process in future cases since these complications are not only found in the immediate postoperative period and should always be in our minds. Abstract P692 Figure.

scholarly journals Surgical treatment of aortic root aneurysm: comparison of Bentall procedure and David reimplantation of aortic valve

2017 ◽  
Vol 63 (10) ◽  
pp. 640-645
Author(s):  
Jiří Ničovský ◽  
Jiří Ondrášek ◽  
Jan Černý ◽  
Daniela Žáková ◽  
Petr Němec
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Root ◽  
Aortic Root Aneurysm ◽  
Bentall Procedure

scholarly journals P1474 Right or left; which sided the infective endocarditis is?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A A Baskurt ◽  
E Ozpelit ◽  
Z Kumral ◽  
B Akdeniz
Keyword(s):  
Infective Endocarditis ◽  
Aortic Root ◽  
Right Atrium ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Replacement Surgery ◽  
Reactive Protein ◽  
The Right

Abstract ABSTRACT Treatment and management of infective endocarditis (IE) depends on the side of involvement. Involvement of both sides of heart is rarely encountered. We describe one case of both sided infective endocarditis caused by staphylococcus auerus. In this case, the vegetation is thought to be on the right side of the heart at first examination by transthrorasic echocardiography (TTE). However; when examined more carefully with transoesophageal echocardiography (TEE), nothing was as it seemed. CASE PRESENTATİON A 86-year-old woman, who underwent mechanic aortic valve replacement surgery 11 years before, was admitted to emergency room with fever, dispnea and cough. Physical examination showed a temperature of 38.6. Electrocardiography showed a atrial fibrillation of 112 beats/min. Laboratory tests revealed an elevated C reactive protein of 211 mg/l. The patient was empirically treated with intravenous piperacillin-tazobactam and teicoplanin, by the recommendation of infection disease unit. Staphylococcus aureus grew in both bottles of blood cultures. A TTE showed severe tricuspid regurgitation with vegetation, mild aortic regurgitation and moderate mitral regurgitation with no clear vegetation. We decided perform TEE and realised the vegetation in the right atrium was originated from the right atrial wall not from the tricuspid valve. Then we also noticed a thickening in the walls of aortic root with systolic expansion. This finding was consistent with paraaortic abscess formation. The 3D TEE examination helped us to understand the origin of the vegetation in the right atrium. Because the wall of the right atrium which the vegetation arised from was in direct continuity with the infected aortic root. We conclude that the paraortic abscess was spread to the right atrium by neighborhood. After one week of IV antibiotics treatment, the patient undergone open heart surgery. The surgical inspection confirmed the echocardiographic diagnosis. DISCUSSION Echocardiography helps us in diagnosis, determination of side of involvement, and complications of infective endocarditis. Usually the endocarditis invole only one side of the heart: left or right. We have found only four cases of double-sided endocarditis in literature. Our case is the first one , in which we describe a direct extension of aortic root abscess to the right atrium. Abstract P1474 figure 1

Bicuspid-Associated Aortic Root Aneurysm: Mid to Long-Term Outcomes of David V Versus the Bio-Bentall Procedure

2021 ◽  
Author(s):  
Stephanie N. Nguyen ◽  
Tsuyoshi Yamabe ◽  
Yanling Zhao ◽  
Paul A. Kurlansky ◽  
Isaac George ◽  
...  
Keyword(s):  
Aortic Root ◽  
Long Term Outcomes ◽  
Aortic Root Aneurysm ◽  
Bentall Procedure

Aortic Dissection Type a after Right Atrial Cryoablation during Port Access Mitral Valve Surgery

2012 ◽  
Vol 7 (5) ◽  
pp. 376-378
Author(s):  
Tatjana Fleck ◽  
Martin Dworschak ◽  
Wilfried Wisser
Keyword(s):  
Multiorgan Failure ◽  
Mitral Valve Surgery ◽  
Minimal Invasive ◽  
Ascending Aorta ◽  
Maze Procedure ◽  
Right Atrial ◽  
Tricuspid Valve Repair ◽  
Port Access ◽  
Right Atrial Appendage ◽  
The Right

The case of a 63-year-old woman who underwent minimal invasive mitral and tricuspid valve repair and a concomitant CryoMaze is described. During creation of the last lesion of the right-sided maze procedure, dissection of the ascending aorta occurred that necessitated emergency sternotomy, replacement of the ascending aorta, and aortocoronary bypass grafting to the right coronary artery (RCA) because of detachment of the RCA from the aortic annulus. Repair of this complication was successful; nevertheless, the patient died 5 days after the operation because of multiorgan failure. The cause of this complication can only be speculated, but a relation to the CyroMaze is obvious. Because of the restricted incision with impaired vision especially in the area of the right atrial appendage, the cryoprobe could have come into contact with the orifice of the RCA during the last lesion, with subsequent detachment of the RCA from the aorta, which could subsequently have caused dissection.

Diseases of the Aorta

2016 ◽  
Author(s):  
Patrizio Lancellotti ◽  
Bernard Cosyns
Keyword(s):  
Thoracic Aorta ◽  
Aortic Root ◽  
Elective Surgery ◽  
Ascending Aorta ◽  
Supplementary Information ◽  
Descending Aorta ◽  
Serial Measurement ◽  
Echocardiographic Examination ◽  
The Right ◽  
Axis View

This chapter considers evaluation of the aorta as a routine part of the standard echocardiographic examination. It looks as TTE as an excellent modality for imaging the aortic root, and in the serial measurement of maximum aortic root diameters, aortic regurgitation evaluation, and timing of elective surgery for several entities. In some patients, the right parasternal long-axis view can provide supplementary information of the ascending aorta. Of major importance for evaluation of the thoracic aorta is the suprasternal view. Although the entire thoracic descending aorta is not well imaged by TTE, the abdominal descending aorta is relatively easily visualized. TEE is safe and can be performed at the bedside. It provides a good visualization of the entire thoracic aorta, with the exception of the distal part of the ascending aorta.

scholarly journals Management of a giant aortic root aneurysm in a young patient with Marfan syndrome: a case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jiayu Shen ◽  
Changping Gan ◽  
R. D. T. Rajaguru ◽  
Dou Yuan ◽  
Zhenghua Xiao
Keyword(s):  
Decision Making ◽  
Aortic Valve ◽  
Ct Scan ◽  
Young Patient ◽  
Aortic Root ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Aortic Root Aneurysm ◽  
Treatment Decision Making ◽  
Bentall Procedure

Abstract Introduction Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age. Case The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed 190.5 cm of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. Transthoracic echocardiography and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we performed Bentall procedure based on the results of multidisciplinary team discussion and intraoperative exploration. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later. Conclusion It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. A mechanical Bentall procedure seems to be an acceptable option for some selected cases.

A rare case of a patient with aortic root aneurysm, bicuspid aortic valve, and Scimitar syndrome with anomalous venous return to the right superior pulmonary vein

2018 ◽  
Vol 28 (4) ◽  
pp. 595-597
Author(s):  
Kamran Ahmadov ◽  
Catherine A. Beigelman ◽  
Matthias Kirsch
Keyword(s):  
Aortic Valve ◽  
Pulmonary Vein ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Rare Case ◽  
Venous Return ◽  
Scimitar Syndrome ◽  
Aortic Root Aneurysm ◽  
Superior Pulmonary Vein ◽  
The Right

AbstractA rare case of Scimitar Syndrome with an abnormal drainage of the right lower pulmonary vein into the right superior pulmonary vein associated with aortic root aneurism and bicuspid aortic valve is reported.

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