Ascending aortic false aneurysm following cannulation for perfusion.

Branchini, B; Zingone, Bartolo; Vaccari, M

doi:10.1136/thx.31.2.234

Cited by 9 publications

(5 citation statements)

References 9 publications

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“…Two of these three cases presented in the early postoperative period and the third one presented late, as in our two cases reported here (Table). Cannulation site aneurysm can present either in the early postoperative period (Flick et al, 1971;Branchini et al, 1976) or may be delayed for years, as reported by Williams et al (1976) and as occurred in our two cases.…”

Section: Discussionmentioning

confidence: 50%

“…The patient's blood is drained into the oxygenator, and thus a bloodless operative field is achieved. Injudicious spreading of the sternum is best avoided if damage to the heart and underlying vessels is to be prevented (Lillehei et al, 1969;Branchini et al, 1976). The tear at the junction of the superior vena cava and innominate artery in our case 2 could thus have been avoided.…”

Section: Discussionmentioning

confidence: 99%

“…There is, however, a remote possibility that the electrical burn over the sternal suture wire in case 1, which occurred at the time of cardioversion, also selectively caused a burn over the aorta with resulting aortic wall necrosis and aneurysmal formation. Neither can a satisfactory explanation be given for the previously published cases with the possible exception of the patient of Branchini et al (1976) in whom difficulty with haemostasis from the cannulation site necessitated the use of extra pledgets of Teflon.…”

Section: Discussionmentioning

confidence: 99%

“…The aneurysm frequently ruptures when the sternum is opened (Lillehei et al, 1969;Branchini et al, 1976) and hence adequate cooling should precede sternotomy so that the circulation can be arrested. The patient's blood is drained into the oxygenator, and thus a bloodless operative field is achieved.…”

Section: Discussionmentioning

confidence: 99%

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Delayed non-mycotic false aneurysm of ascending aortic cannulation site.

Soorae¹,

Cleland²,

O'Kane³

1977

Thorax

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. (1977). Thorax, 32,[743][744][745][746][747][748] Delayed non-mycotic false aneurysm of ascending aortic cannulation site. Two cases of delayed non-mycotic false aneurysm arising from the ascending aortic cannulation site, presenting one-and-a-half years and seven years after cardiopulmonary bypass, are described. These two cases represent an incidence of 0O12% of this complication. Repair using profound hypothermia and circulatory arrest with femoral artery and femoral vein cannulation for cardiopulmonary bypass is recommended. The advantages and complications of aortic cannulation are discussed and recommendations to minimise the complications of cannulation are made. The clinical presentation and diagnosis of non-mycotic false aneurysms arising from the aortic cannulation site are described. In addition one delayed and two early cases of non-mycotic cannulation site false aneurysms previously published are analysed. Surgeons should be alert to the possibility of this complication in all patients who have had aortic cannulation for cardiopulmonary bypass even in ithe distant past. Unexpected symptoms such as constant anterior chest pain, dysphagia, hoarseness, and increasing widening of the superior mediastinum on the chest radiograph warrant prompt investigation.Delayed non-mycotic false aneurysm arising from the ascending aortic cannulation site is a rare complication of this technique for arterial return in cardiopulmonary bypass, and only one case has been reported previously (Williams et al., 1976 Table). Cannulation and decannulation were carried out uneventfully and the sternotomy wound healed satisfactorily. The postoperative progress was uncomplicated and he was discharged from hospital two weeks after the operation. He was seen regularly in the outpatient department and within six months he was working a 12-hour day on his farm. However, he remained in atrial fibrillation and 10 months later he underwent an unsuccessful attempt at DC cardioversion. During this procedure a small burn was produced over one of the sternal suture wires at the level of the manubriosternal junction, possibly due to inappropriate contact with the electrode. This ultimately resulted in a sinus in which the sternal wire could be easily palpated. This sinus was excised and the sternal wire removed. Histological examination showed a foreign-body reaction with chronic inflammatory cells but culture from the area was sterile.The patient was readmitted to hospital in February 1971 with a fluctuant swelling in the upper third of the sternotomy scar at the site of the previous sinus. This produced serosanguinous fluid when incised, but no organisms were cultured from the fluid. As he had a low-grade pyrexia, 743 on 3 April 2019 by guest. Protected by copyright.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Delayed non-mycotic false aneurysm of ascending aortic cannulation site.

Soorae¹,

Cleland²,

O'Kane³

1977

Thorax

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“…Fals e aneurysm of th e as cending aorta, a rare complication of cardiac surger y, has been reported as arising from th e aortic cannulation site (2), needle puncture sites, and the aortic suture line (11). The pr esentation of a false an eurysm as an aorto-cutaneous fistula has not been previously described.…”

Section: Introductionmentioning

confidence: 99%

Aorto-cutaneous Fistula: A Rare Complication of Aortic Surgery

Bj¹,

Tsang²,

Pepper³

et al. 1992

Thorac cardiovasc Surg

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Two cases of false aneurysm of the ascending aorta which presented with discharge of arterial blood from a sternal wound are discussed. The first presented 8 years after aortic valve surgery and was diagnosed by contrast enhanced computerised tomography of the thorax. The second presented 6 months following repair of an aortic dissection and the diagnosis was confirmed by thoracic magnetic resonance imaging. The diagnosis and surgical management of these cases are reviewed.

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Pseudoaneurysm at the cannulation site of the ascending aorta arising 8 days postoperatively: report of a case

et al. 2012

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A postoperative pseudoaneurysm is a rare complication that is difficult to diagnose. Computed tomography (CT) revealed a pseudoaneurysm in the ascending aorta of a 68-year-old female 8 days after mitral valve replacement and tricuspid annuloplasty. The defect was simply repaired during emergency surgery without cardiopulmonary bypass (CPB). The early detection of a postoperative pseudoaneurysm is important to avoid a second operation complicated by adhesions. Enhanced CT was useful for early detection in this patient. Pseudoaneurysm of the ascending aorta at the cannulation site can occur soon after surgery, and early recognition might allow simpler surgery without CPB.

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Ascending aortic false aneurysm following cannulation for perfusion.

Cited by 9 publications

References 9 publications

Delayed non-mycotic false aneurysm of ascending aortic cannulation site.

Delayed non-mycotic false aneurysm of ascending aortic cannulation site.

Aorto-cutaneous Fistula: A Rare Complication of Aortic Surgery

Pseudoaneurysm at the cannulation site of the ascending aorta arising 8 days postoperatively: report of a case

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