Tratamento cirúrgico de aneurisma de aorta ascendente: observação ecocardiográfica simultânea dos óstios coronarianos reimplantados em prótese vascular

Abstract

A 52-year-old man was admitted for surgical treatment of the ascending aorta aneurysm and aortic valve regurgitation. Upon presentation, he was found to have third heart sound (S3), 6/6+ diastolic murmur at the aortic area, and blood pressure of 3160 x 50 mm Hg. Multiplane transesophageal echocardiography (TEE) showed aneurysm of the ascending aorta measuring 7.3 cm (Figure 1), left ventricular diastolic diameter of 8.3 cm, left ventricular ejection fraction of 0.40 (Simpson's method), and severe aortic valve regurgitation. Echocardiographic findings were confirmed by chest tomographyThe patient underwent a Dacron (Figure 2) aortic prosthesis implantation and aortic valve replacement using a Saint-Jude Key wordsAorta, aneurysm, surgery, echocardiophy. mechanical prosthesis Nº 27. Coronary ostia were reimplanted to the vascular prosthesis (Figure 3). Right coronary ostium was reimplanted above its anatomic position. Both reimplanted coronary ostia were simultaneously shown during intraoperative transesophageal echocardiogram. Blood flow at the left main coronary artery reimplanted to the vascular prosthesis is shown in figures 4 and 5. The patient evolved uneventfully in the postoperative period and was discharged ten days after surgical correction.

A novel parasternal transthoracic echocardiographic window for detecting coronary ostial dilation after modified Bentall surgery

“…Veira et al reported a dilated appearance of the aortic-coronary artery anastomosis site of a patient immediately following composite aortic root and valve replacement using intraoperative transoesophageal echocardiogram [15], suggesting that the coronary ostial dilation could be an immediate consequence of the surgery. However, it is not known if the dilation can increase with time.…”