scholarly journals A Case of Catastrophic Pulmonary Bleeding That Occurred after Extensive graft Replacement of the Ascending, Transverse Aortic Arch and the Descending Thoracic Aorta.

1994 ◽  
Vol 23 (3) ◽  
pp. 179-185
Author(s):  
Koki Tsuchida ◽  
Akimasa Hashimoto ◽  
Shigeyuki Aomi ◽  
Touitsu Hirayama ◽  
Masahiro Endo ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Descending Thoracic Aorta ◽  
Graft Replacement ◽  
Pulmonary Bleeding

scholarly journals Treating the patient with acute rupture of penetrating atherosclerotic ulcer of the thoracic aorta

2015 ◽  
Vol 96 (3) ◽  
pp. 377-380
Author(s):  
I R Yagafarov ◽  
R R Sayfullin ◽  
M M Iskhakov ◽  
N V Gazizov ◽  
M G Khatypov ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Spontaneous Rupture ◽  
Open Surgery ◽  
Intraoperative Complications ◽  
Long Term Results ◽  
Safe Procedure ◽  
Descending Thoracic Aorta ◽  
Prosthetic Repair ◽  
Penetrating Atherosclerotic Ulcer

Spontaneous rupture of the aorta - a violation of the integrity of the aortic wall which is not caused by an aneurysm, trauma, dissection or disintegrating tumor process, and is an acute life-threatening condition. According to some authors, the main cause of spontaneous rupture of the aorta is a penetrating atherosclerotic ulcer of the aorta, which is an ulceration of aortic atherosclerotic plaque leading to penetration of the internal elastic plate in media. We present a case of successful hybrid surgical treatment of patient with spontaneous rupture of the descending thoracic aorta with the formation of para-aortic hematoma and left-sided hemothorax. The patient underwent a hybrid operation - aortic arch and descending thoracic aorta prosthetic repair, subclavian bypass with left subclavian artery ligation, left-sided thoracotomy, and pleural cavity sanitation. No intraoperative complications were observed, the patient was taken off the ventilator on day 2. The control computed tomography performed on day 10, revealed correct and stable stent graft position with no signs of continued bleeding, endoleak. The patient was discharged in satisfactory condition on day 14. Due to the high hospital mortality of open surgery on the thoracic aorta in case of penetrating atherosclerotic ulcers, as well as the predominance of elderly patients with severe comorbidities that contraindicate open surgery using cardiopulmonary bypass, endovascular and hybrid technologies, which are minimally invasive and traumatic, come to the fore. Endovascular prosthetic repair in case of penetrating atherosclerotic ulcer of aortic arch and descending thoracic aorta is an effective and safe procedure in patients at high risk, showing encouraging long-term results.

scholarly journals Hybrid Repairs of the Distal Aortic Arch and Proximal Descending Thoracic Aorta

2007 ◽  
Vol 12 (3) ◽  
pp. 167-177 ◽  
Author(s):  
John Bozinovski ◽  
Scott A. LeMaire ◽  
Scott A. Weldon ◽  
Joseph S. Coselli
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Descending Thoracic Aorta

SUCCESFULL SURGICAL REPAIR OF AN ACCUTE TYPE A DISSECTING AORTIC ANEURYSM ASSOCIATED WITH A RIGHT-SIDED-AORTIC ARCH AND RIGHT SIDED DESCENDING THORACIC AORTA

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 416S ◽  
Author(s):  
Konstantinos E. Paziouros ◽  
Stavros Siminelakis ◽  
Sokrates Sismanidis ◽  
Leonidas Disnitsas ◽  
Miltiadis Matsagas ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Surgical Repair ◽  
Type A ◽  
Descending Thoracic Aorta ◽  
Dissecting Aortic Aneurysm

scholarly journals Endovascular repair of a Kommerell's diverticulum in a patient with a left-sided aortic arch and right-sided descending thoracic aorta

2009 ◽  
Vol 49 (6) ◽  
pp. 1577-1579 ◽  
Author(s):  
Paul J. Riesenman ◽  
Chase L. Campbell ◽  
Mark A. Farber
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Endovascular Repair ◽  
Descending Thoracic Aorta ◽  
Kommerell’S Diverticulum

scholarly journals Sequential ruptures of penetrating atherosclerotic ulcers of ascending aorta, aortic arch and descending thoracic aorta

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Pankaj Kaul ◽  
Rodolfo Paniagua ◽  
Afroditi Petsa ◽  
Raj Singh
Keyword(s):  
Renal Cell Carcinoma ◽  
Case Report ◽  
Thoracic Aorta ◽  
Renal Cell ◽  
Ascending Aorta ◽  
Descending Thoracic Aorta ◽  
Graft Replacement ◽  
Penetrating Ulcer ◽  
Similarities And Differences ◽  
Aortic Dissections

Abstract Background Penetrating ulcers of aorta, aortic dissections and intramural hematomas all come under acute aortic syndromes and have important similarities and differences. Case report We report a 67 year old man with rupture of a large penetrating ulcer of the distal ascending aorta with hemopericardium and left hemothorax. He underwent interposition graft replacement of ascending aorta and hemi-arch with a 30 mm Gelweave Vascutek graft but represented 6 months later with development of a penetrating ulcer which ruptured into a huge 14 cm pseudoaneurysm. This was repaired with a 28 mm Vascutek Gelseal graft replacement of arch and interposition graft reconstruction of innominate and left common carotid arteries. 6 weeks later, however, he ruptured his proximal descending aorta and underwent TEVAR satisfactorily. Unfortunately, 2 days later, he developed a pathological fracture of left proximal tibia with metastasis from a primary renal cell carcinoma. He died 3 weeks later from respiratory failure. We shall briefly outline the similarities and differences in presentation and management of penetrating aortic ulcers, aortic dissections and intramural haematomas. We shall discuss, in greater detail, penetrating ulcers of thoracic aorta, their natural history, location, complications and management. Conclusion This case report is unique on account of initial successful surgical redressal following rupture of penetrating ulcer of distal ascending aorta into left pleural and pericardial cavities, normally associated with instant death. The haemodynamic effects of the rupture were staggered due to initial contained rupture into a smaller pseudoaneurysm, followed by a further rupture into a false aneurysmal sac followed eventually by generalised rupture into the pleural and pericardial cavities - a unique way of aortic rupture. Further development of another penetrating ulcer and a small pseudoaneurysm in the distal arch 6 months later which further ruptured into a larger 14 cm false aneurysmal sac, which again did not result in exsanguination, is again extraordinarily rare. Thereafter he underwent emergency thoracic endovascular aortic repair (TEVAR) for a further rupture of descending thoracic aorta. All three ruptures were managed successfully and would usually be associated with near-certain death, only for the patient to succumb eventually to the complications of metastatic renal cell carcinoma.

scholarly journals VASCULAR RING- LEFT AORTIC ARCH WITH RIGHT DESCENDING THORACIC AORTA AND RIGHT LIGAMENTUM ARTERIOSUM

2017 ◽  
Vol 4 (26) ◽  
pp. 1568-1571
Author(s):  
Jai Prakash Soni ◽  
Mohan Makwana ◽  
Suresh Kumar ◽  
Kirti Chaturvedi ◽  
Pradeep Singh ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Vascular Ring ◽  
Descending Thoracic Aorta ◽  
Ligamentum Arteriosum

scholarly journals Sequential ruptures of penetrating atherosclerotic ulcers of ascending aorta, aortic arch and descending thoracic aorta

2020 ◽  
Author(s):  
Pankaj Kaul ◽  
Rodolfo Paniagua ◽  
Afroditi Petsa ◽  
Raj Singh
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Thoracic Aorta ◽  
Renal Cell ◽  
Ascending Aorta ◽  
Descending Thoracic Aorta ◽  
Graft Replacement ◽  
Interposition Graft ◽  
Penetrating Ulcer ◽  
Aortic Dissections

Abstract BackgroundPenetrating ulcers of aorta, aortic dissections and intramural hematomas all come under acute aortic syndromes and have important similarities and differences.Case ReportWe report a 67 year old man with rupture of a large penetrating ulcer of the distal ascending aorta with hemopericardium and left hemothorax. He underwent interposition graft replacement of ascending aorta and hemi-arch with a 30 mm Gelweave Vascutek graft but represented 6 months later with development of a penetrating ulcer which ruptured into a huge 14 cm pseudoaneurysm. This was repaired with a 28 mm Vascutek Gelseal graft replacement of arch and interposition graft reconstruction of innominate and left common carotid arteries. 6 weeks later, however, he ruptured his proximal descending aorta and underwent TEVAR satisfactorily. Unfortunately, 2 days later, he developed a pathological fracture of left proximal tibia with metastasis from a primary renal cell carcinoma. He died 3 weeks later from respiratory failure.We shall briefly outline the similarities and differences in presentation and management of penetrating aortic ulcers, aortic dissections and intramural haematomas. We shall discuss, in greater detail, penetrating ulcers of thoracic aorta, their natural history, location, complications and management.ConclusionThis case report is unique on account of initial successful surgical redressal following rupture of penetrating ulcer of distal ascending aorta into left pleural and pericardial cavities, normally associated with instant death. The haemodynamic effects of the rupture were staggered due to initial contained rupture into a smaller pseudoaneurysm, followed by a further rupture into a false aneurysmal sac followed eventually by generalised rupture into the pleural and pericardial cavities - a unique way of aortic rupture. Further development of another penetrating ulcer and a small pseudoaneurysm in the distal arch 6 months later which further ruptured into a larger 14 cm false aneurysmal sac, which again did not result in exsanguination, is again extraordinarily rare. Thereafter he underwent emergency thoracic endovascular aortic repair (TEVAR) for a further rupture of descending thoracic aorta. All three ruptures were managed successfully and would usually be associated with near-certain death, only for the patient to succumb eventually to the complications of metastatic renal cell carcinoma.

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