FISTULIZATION OF A GIANT PSEUDOANEURYSM OF CIRCUMFLEX ARTERY TO LEFT ATRIUM LEADING TO SEVERE MYOCARDIAL ISCHEMIA: A VERY RARE CASE

We present a successful surgical treatment of a 75x70mm circumflex coronary artery pseudoaneurysm detected incidentally in a 48-year-old male patient. Successful correction was made by repairing the fistulized area in the left atrium and the ‘neck’ in the pseudoaneurysm.

Pseudoaneurysma van de arteria hepatica sinistra bij een patiënt met chronische pancreatitis gecompliceerd met obstructieve icterus

Pseudoaneurysm of the left hepatic artery in a patient with chronic pancreatitis complicated with obstructive jaundice. A pseudoaneurysm of the left hepatic artery that causes an obstructive jaundice is a rare entity that has only been described a few times in scientific literature. We describe the case of a patient with a giant pseudoaneurysm (10 cm diameter) caused by chronic pancreatitis, that compresses the choledochus duct. The diagnosis was made by CT scan (computed tomography). The treatment consisted of a ligation of the afferent and efferent artery and evacuation of the aneurysmatic mass. A persisting bile leak was caused by a haemobiliary fistula between the aneurysmatic sac and choledochus duct. Therefore, a hepaticojejunostomy was performed with a delay of 4 weeks. The patient recovered after a few weeks and left the hospital in a good condition.

Surgical Treatment of Chronic Giant Left Ventricular Pseudoaneurysm

Left ventricle pseudoaneurysm is usually a severe complication of acute myocardial infarction, caused by rupture of the myocardial wall with pericardium bleeding. Mortality can reach 50 to 80% within a week if not properly treated. Hemodynamic instability, cardiac tamponade, and cardiac arrest are life-threatening presentations that require surgical treatment. We report a case of a man with a left ventricle chronic giant pseudoaneurysm and unspecific symptoms. After critical judgement on a heart team basis, surgical treatment was successfully performed, with a good long-term clinical outcome.