Thoracic aortic aneurysm (TAA) is generally a disease of the elderly which remains mostly asymptomatic. It is often detected incidentally with imaging studies of the chest done for other reasons. We present a 55year-old smoker, normotensive and non-diabetic male patient who was diagnosed as a case of TAA and treated by endovascular means with thoracic endovascular aortic repair (TEVAR) technique. Due to small caliber femoral artery, thoracic endograft was deployed through a Dacron graft conduit of 10 mm diameter which was anastomosed to the common iliac artery. It was a hybrid procedure done in cardiac catheterization laboratory under general anesthesia. Completion angiogram revealed good technical success with no endoleak or neurological deficit. Patient improved symptomatically after TEVAR.
Bangladesh Heart Journal 2019; 34(2) : 146-150
Introduction:Coronary artery disease is the most common form of heart disease and the single most important cause of premature death in the developed world. 1 Surgical management of IHD is coronary artery bypass graft surgery (CABG), which can be performed either under cardiopulmonary bypass (CPB) or by using off-pump technique. Impairment of pulmonary function after CABG is one of the most common complications in the early postoperative period. 2 Sternotomy, pleurotomy with opening of the pleural space, harvesting of internal mammary artery and pain may lead to deterioration of post-operative pulmonary function. In addition, the incidence of concurrent chronic lung disease is higher in the age group of patients who require revascularization of the myocardium. Combined these two factors indicate a need for documentation of pulmonary function pre-and postoperatively. 3 Coronary revascularization procedure is done usually through median sternotomy incision and for this; impairment of pulmonary function is one of the most significant post-operative complications of CABG. 4 For revascularization, emphasis is given over internal mammary artery (IMA) graft. The mediastinum and thoracic cavity are traumatized more with IMA than with reverse saphenous vein graft (RSVG) procedure. Indeed, some reports have found that IMA patients have worse pulmonary functions than the RSVG patients in the postoperative period. 5 Basal atelectasis develops early during anaesthesia and may persist in the post-operative period. After surgery both respiratory muscles
Superior mesenteric artery (SMA) aneurysm is a rare vascular entity and may present with a wide range of symptoms. They are often symptomatic, presenting with thromboembolic intestinal angina. They have a high risk of rupture and may present with gastro-intestinal bleeding, associated with high morbidity and mortality. We report the case of a 14year-old boy who presented with chronic abdominal pain and weight loss, in which SMA aneurysm was diagnosed after radiological evaluation. He underwent successful excision of aneurysmal sac along with aorto-mesenteric bypass using polytetrafluoroethylene (PTFE) graft, and had an uneventful recovery.Cardiovasc. j. 2016; 8(2): 161-164
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