Endovascular approach to treat aortic pseudoaneurysms: could it be a safe alternative?

The Heart Surgery Forum
Altarabsheh Salah EldienLyle Joyce

Abstract

Aortic pseudoaneurysm is a rare complication after blunt chest trauma or cardiac surgical procedures and can occur at the site of cannulation or root vent insertion on the ascending aorta. These pseudoaneurysms have the potential to expand, erode, and rupture, and detecting this condition before complications occur is the key to successful management. We had replaced the mitral valve with a 31-mm bioprosthesis in an 82-year-old patient and repaired an ascending aorta aneurysm, but a computed tomography scan on postoperative day 18 revealed a pseudoaneurysm at the site of the previous aortic cannulation. Because of the patient's advanced age and multiple comorbidities, we sealed off the neck of the pseudoaneurysm with a 12-mm Amplatzer Vascular Plug in the interventional cardiology suite instead of subjecting her to a surgical repair involving redo sternotomy and a period of circulatory arrest. Deployment of the Amplatzer plug effectively shut off flow into the pseudoaneurysm, and the patient recovered well. Although the optimal management strategy for aortic pseudoaneurysms is a matter of controversy, endovascular interventions may be a safer alternative to surgery for patients with multiple comorbidities.

References

Oct 1, 1987·Journal of the American College of Cardiology·H E SanerK J Elsperger
Apr 5, 2002·Journal of Vascular Surgery·James I FannRonald L Dalman
Oct 16, 2003·Journal of Vascular Surgery·Timothy A M ChuterLouis M Messina
Jun 30, 2004·The Annals of Thoracic Surgery·Eric DumontLouis P Perrault
Dec 2, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ronak S KananiJoseph M Garasic

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Citations

Feb 13, 2014·Annals of Vascular Surgery·Vikalp JainShang A Loh
Dec 15, 2015·The Annals of Thoracic Surgery·Yu-Guo XueLian-Jun Huang
May 5, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Stephen M LyenMark Turner

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Aortic Aneurysm

An aortic aneurysm is the weakening and bulging of the blood vessel wall in the aorta. This causes dilatation of the aorta, which is usually asymptomatic but carries the risk of rupture and hemorrhage. Find the latest research on aortic aneurysms here.

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