Reoperation for pseudoaneurysm of the thoracic aorta after cardiovascular surgery

Abstract

Regular follow-up, including imaging modalities and physical examinations, is mandatory to detect aortic pseudoaneurysms after cardiovascular surgery.

Percutaneous endovascular management of ascending aortic pseudoaneurysm after heart transplantation in a pediatric patient

“…1,9 Some predisposing factors are graft infection, trauma, tissue fragility in the anastomosis area, aortic cannulation sites, cardioplegic cardiac puncture, a dissected native aorta, and tissue necrosis due to biological glue. 1,2,10 The clinical features can be dyspnea, hemoptysis, chest pain, respiratory failure, and cardiogenic shock. 4,10,11 Although some patients can remain asymptomatic, pseudoaneurysms are incidental findings of imaging examinations.…”

“…1,2,10 The clinical features can be dyspnea, hemoptysis, chest pain, respiratory failure, and cardiogenic shock. 4,10,11 Although some patients can remain asymptomatic, pseudoaneurysms are incidental findings of imaging examinations. 1,4 Usually, small pseudoaneurysms do not cause clinical manifestations, but a periodic follow-up is needed to monitor the dimensions and re-evaluate possible therapeutic options.…”

Outcomes of surgical repairs for thoracic aortic pseudoaneurysms after cardiovascular surgery

“…Half of the patients were asymptomatic in our series. We now strictly follow‐up patients who undergo cardiovascular surgery every six or twelve months, for life, even in the absence of symptoms . This is especially justified in patients with recognized risk factors for aortic pseudoaneurysms such as aortic dissection, connective tissue disorder, graft infection, or mediastinits …”

“…We described our techniques for reoperation for thoracic pseudoaneurysm in detail in our previous report . Cardiopulmonary bypass is initiated before resternotomy when there is a possibility of rupture or injury based on preoperative computed tomographic images.…”

“…The reported mortality rate ranges from 14.3% to 17.2%. [1][2][3] Because of its rarity (incidence rate less than 0.5% 4,5 ), there is little information regarding perioperative and longterm outcomes. Recent improvements in endovascular techniques have been applied to repair thoracic aortic pseudoaneurysms, and are particularly beneficial in the elderly or high-risk patients compared with open surgery.…”