Fate of coronary ostial anastomoses after the modified Bentall procedure

Milano, Aldo Domenico; Pratali, Stefano; Mecozzi, Gianclaudio; Boraschi, Piero; Braccini, G; Magagnini, E; Bortolotti, Uberto

doi:10.1016/s0003-4975(03)00015-8

Cited by 63 publications

(43 citation statements)

References 20 publications

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“…In multiple, large single center reports (8)(9)(10)14,22), pseudoaneurysm rates were well within the expected range for these disease states, which has been reported to be as high as 6.0% (27,28). In a series of 95 type A dissections in which late pseudoaneurysm occurred in some patients treated with GRF glue, Westaby and colleagues noted that this complication was not associated with BioGlue (29).…”

Section: Discussionmentioning

confidence: 64%

Does BioGlue contribute to anastomotic pseudoaneurysm after thoracic aortic surgery?

Ziganshin

Guo

et al. 2017

J. Thorac. Dis.

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Background: Although bovine serum albumin-glutaraldehyde glue (BioGlue®) has been successfully used as a hemostatic adjunct in aortic surgical procedures, there are reports that it may lead to anastomotic pseudoaneurysm formation. We seek to examine if the use of BioGlue is associated with a high incidence of anastomotic pseudoaneurysm formation following surgical repair of thoracic aortic disease. Methods:We reviewed the medical records and follow-up computed tomography (CT) scans of patients from 2001 to 2015 in whom BioGlue was used during surgical repair of thoracic aortic disease to detect postoperative anastomotic pseudoaneurysm formation.Results: A total of 233 patients with BioGlue use were identified. Mean age was 63.5±14.0 years (median 66; range 14-88; 25-75%, IQR 54-74 years) and 149 were male (63.9%). Surgical indication was thoracic aortic aneurysm in 169 (72.5%) patients, aortic dissection in 49 (21.0%), intramural hematoma in 9 (3.9%), penetrating aortic ulcer in 3 (1.3%) and other in 3 (1.3%). Emergency/urgent surgery was performed in 68 cases (29.2%). Operative mortality was 7.3% (17/233). Re-exploration for bleeding and neurologic deficits occurred in 24 (10.3%) and 21 (9.0%) patients respectively. All operative survivors were followed (100%, 216/216) and CT follow-up was available in 81.9% (177/216) for a mean duration of 2.4 years (median 0.6; 25-75% IQR 0.2-3.6 years). Anastomotic pseudoaneurysm was detected in 1 patient (0.6%) at 3 years postoperatively. This was an elderly female with extremely frail tissues who underwent a reoperative ascending and arch replacement for dissection. Conclusions:The use of BioGlue in thoracic aortic surgery was not associated with excess incidence of anastomotic pseudoaneurysm formation following surgical repair of thoracic aortic disease. Its use need not be discouraged on this basis.

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Section: Discussionmentioning

confidence: 64%

Does BioGlue contribute to anastomotic pseudoaneurysm after thoracic aortic surgery?

Ziganshin

Guo

et al. 2017

J. Thorac. Dis.

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“…The incidence of the suture line disruption was 1 per 191 patient-years, or 1 per 296 anastomosis-years. Milano et al 6 who reviewed 71 patients receiving a composite aortic conduit reported 4 patients (6 %) with anastomotic complications. In 2 a pseudoaneurysm developed at the distal aortic suture line and in 1 a pseudoaneurysm developed after the repair of an acute aortic dissection of the right coronary ostium.…”

Section: Discussionmentioning

confidence: 99%

Combination of Two Pseudoaneurysms in a Patient 6 Years After Ascending Aorta and Aortic Valve Replacement

Brát¹,

Daněk²,

Maly³

2007

BIOMED PAP

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Background:We report successful treatment of a patient 6 years after ascending aorta and aortic valve replacement suff ering from a combination of two pseudoaneurysms. The fi rst of them originated from the coronary ostial suture line and the second pseudoaneurysm originated from the distal suture line.Methods: We performed re-replantation of the left main trunk to the prosthesis and then we resected the pseudoaneurysm originating from the distal suture line and we replaced the entire aorta by a vascular graft.Results: The postoperative convalescence was uneventful, the patient was discharged two weeks after the surgery. The patient is currently in a very good condition one year after the surgery.Conclusions: Coronary ostial pseudoaneurysm in patients after ascending aorta and aortic valve replacement with the use of "button technique" is a quite rare situation. The combination of two pseudoaneurysms originating from diff erent suture lines in one patient seems to be unique in literature reviews.

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“…The imaging appearance of the retroaortic conduit may be mistaken for an intimal flap related to aortic dissection (51,52). Complications following composite valve graft surgery include aortic dissection, anastomotic leak, pseudoaneurysm formation at the coronary artery anastomosis, and coronary graft thrombosis (51,53).…”

Section: Surgical Approaches Composite Valve Graftmentioning

confidence: 99%