Reoperation for ascending aorta false aneurysm using deep hypothermia and circulatory arrest

Oumeiri, Bachar Ghassan El; Louagie, Yves; Buche, Michel

doi:10.1510/icvts.2010.262378

Cited by 18 publications

(18 citation statements)

References 13 publications

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“…In reoperation for thoracic aortic pseudoaneurysms, the most important factor is reentering the chest safely. High mortality rates are often a consequence of fatal bleeding or cerebral air embolism during resternotomy …”

Section: Discussionmentioning

confidence: 99%

“…Oumeiri et al described operative outcomes in seven patients with ascending false aneurysms. The authors used deep hypothermic circulatory arrest with the rectal temperature lowered to 18° by peripheral cannulation during resternotomy, with no fatal complications.…”

Section: Discussionmentioning

confidence: 99%

“…A thoracic aortic pseudoaneurysm is a life‐threatening complication after cardiovascular surgery. The reported mortality rate ranges from 14.3% to 17.2% . Because of its rarity (incidence rate less than 0.5%), there is little information regarding perioperative and long‐term outcomes.…”

mentioning

confidence: 99%

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Outcomes of surgical repairs for thoracic aortic pseudoaneurysms after cardiovascular surgery

Fukunaga

Koyama

2016

J Card Surg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes of surgical repairs for thoracic aortic pseudoaneurysms after cardiovascular surgery

Fukunaga

Koyama

2016

J Card Surg

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“…2,4 Pseudoaneurysms more than 55 mm in diameter, emergency surgery and sepsis during surgery are associated with worse outcomes. 5,6 Survival at one year after hospital discharge is over 90%, and freedom from reoperation is around 70% at five and 10 years. 2,4 Some authors advocate annual follow-up with contrastenhanced thoracic CT for patients who have undergone aortic surgery with a view to early detection of this complication, thus enabling surgical repair in optimal conditions and a better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic aortic pseudoaneurysm: A forgotten complication

Almeida

Bico

Almeida

et al. 2014

Revista Portuguesa de Cardiologia (English Edition)

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Pseudoaneurysms of the ascending aorta are a rare complication of cardiac surgery. However, the poor prognosis associated with this condition if untreated makes early diagnosis and treatment important.We present the case of a 66-year-old woman who had undergone mitral valvuloplasty 12 days previously, who was admitted with a diagnosis of new-onset atrial fibrillation.The transthoracic echocardiogram showed a thrombus in the right atrium and anticoagulation was initiated, followed by antibiotic therapy.After further investigation, the patient was diagnosed with a pseudoaneurysm of the ascending aorta and underwent surgical repair, followed by six weeks of antibiotic therapy.She was readmitted six months later for an abscess of the lower sternum and mediastinum. After a conservative approach with antibiotics and local drainage failed, recurrence of a large pseudoaneurysm compressing the superior vena cava was documented. A third operation was performed to debride the infected tissue and to place an aortic allograft. There were no postoperative complications. © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L. All rights reserved. PALAVRAS-CHAVEPseudoaneurisma da aorta ascendente; Valvuloplastia mitral; Complicação pós-cirurgia cardíaca Pseudoaneurisma iatrogénico da aorta ascendente: uma complicação esquecidaResumo O pseudoaneunisma da aorta ascendente é uma complicação rara da cirurgia cardíaca. A sua elevada mortalidade torna importante o seu diagnóstico atempado e intervenção precoce.Os autores apresentam o caso de uma doente do sexo feminino, submetida a valvuloplastia mitral 12 dias antes, internada com o diagnóstico de fibrilhação auricular com resposta ventricular rápida. O ecocardiograma transtorácico inicial mostrou imagem sugestiva de trombo na aurícula direita, iniciou-se anticoagulação, seguida de terapêutica antibiótica. Investigação adicional com recurso a TC de tórax com contraste endovenoso permitiu concluir que se tratava de um pseudoaneurisma da aorta ascendente, pelo que a doente foi submetida a correção cirúrgica do mesmo, seguida de seis semanas de terapêutica antibiótica dirigida.A doente foi reinternada seis meses depois por abcesso na porção inferior do externo e mediastino. Após falha da terapêutica conservadora, com antibiótico e drenagem local, com agravamento clínico da doente, documentou-se reaparecimento de pseudoaneurisma de grandes dimensões com compressão da veia cava superior. Foi então submetida a terceira intervenção cirúrgica com desbridamento do tecido infetado e implantação de homoenxerto aórtico. O pós-operatório decorreu sem intercorrências.

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“…3 Pseudoaneurysms larger than 55 mm in diameter, those needing emergency intervention, and those associated with sepsis carry a poor prognosis. 4,5 The operative management of large ascending aortic pseudoaneurysm remains technically challenging and is associated with high morbidity and mortality rates.…”

Section: Commentmentioning

confidence: 99%

Ascending Aortic Pseudoaneurysm: Sleeping Giant Arises in 3rd Decade after Surgery

Aggarwal¹,

Banga²,

Mungee³

2016

Texas Heart Institute Journal

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Reoperation for ascending aorta false aneurysm using deep hypothermia and circulatory arrest

Abstract: Resternotomy under circulatory arrest and deep hypothermia is a safe technique well-adapted to patients with an ascending aorta false aneurysm.

Cited by 18 publications

References 13 publications

Outcomes of surgical repairs for thoracic aortic pseudoaneurysms after cardiovascular surgery

Outcomes of surgical repairs for thoracic aortic pseudoaneurysms after cardiovascular surgery

Iatrogenic aortic pseudoaneurysm: A forgotten complication

Ascending Aortic Pseudoaneurysm: Sleeping Giant Arises in 3rd Decade after Surgery

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