Successful Surgical Treatment of a Giant Mediastinal False Aneurysm 30 Years after Bentall Operation

Abstract

False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.

Long‐term follow‐up after Bentall operation using a stentless Shelhigh NR‐2000 bio‐conduit

“…We reported the case of a patient presenting with complete detachment of the right coronary ostium anastomosis and giant mediastinal false aneurysm formation diagnosed 30 years after Bentall operation. 23 Tsunekawa et al 24 In conclusion, in our experience, the full root replacement with stentless Shelhigh NR-2000 prosthesis through a Bentall operation achieved satisfactory results, with excellent hemodynamics, low gradients, and remarkable results. The operative risk was acceptable and long-term results were satisfactory.…”

“…The interval between surgery and the onset of complications is variable and can be quite wide. We reported the case of a patient presenting with complete detachment of the right coronary ostium anastomosis and giant mediastinal false aneurysm formation diagnosed 30 years after Bentall operation 23 . Tsunekawa et al 24 published their experience with 273 patients undergoing Bentall operation using a composite home‐made biological valved Dacron tube with a mean follow‐up of 107 months.…”