Surgical Repair of a Pseudoaneurysm of the Ascending Aorta to Pulmonary Artery Fistula after Replacement of the Ascendan Aorta and Aortic Valve

Ilhan Golbasi, Cemal Kemaloglu, Ozan Erbasan and Ömer Bayezid

Department of Cardiac and Vascular Surgery, Akdeniz University, Turkey

^*Correspondance to: Ilhan Golbasi 

 PDF  Full Text DOI: 10.25107/2474-1647.1534

Abstract

We report the case of a patient with a pseudoaneurysm of the ascending aorta with right pulmonary artery fistula diagnosed after aortic valve and supra-coronary ascending aorta replacement for aortic dissection 4 years previously. He was referred to our hospital because of dyspnea and chest pain. A preoperative diagnostic evaluation revealed a pseudoaneurysm of the ascending aorta (10 cm × 9 cm × 7 cm) close to the proximal anastomotic site of the graft. During surgery, it was determined that the pseudoaneurysm originated from an intimal defect in the aortic wall on the right side of the left coronary artery at the proximal suture line. Pseudoaneurysm of the ascending aorta with pulmonary artery fistula was closed by a 2.5 cm × 4 cm PTFE patch, and aortic defect was repaired with a 1, 5 cm × 2 cm PTFE patch using a femorofemoral bypass. The patient was discharged 9 days later and remained well at a follow-up 6 months thereafter. Pseudoaneurysm after aortic valve and ascending aorta replacement develops usually due to aortic graft anastomotic dehiscence, infectious, periannular abscess, and perigraft hematoma. Erosion into the pulmonary artery with resultant fistula formation may develop probably due to continuous pulsatile friction between the pseudo-aneurysmatic wall and pulmonary artery. Pseudoaneurysm with aorta-pulmonary fistula is an extremely rare and significant complication following aortic surgery. We report the case of a patient with pseudoaneurysm of the ascending aorta with right pulmonary artery fistula that was successfully repaired surgically.

Keywords

Aortic pseudoaneurysm; Aortic root replacement; Ascending aorta aneurysm; Aorta to pulmonary artery fistula

Cite the article

Golbasi I, Kemaloglu C, Erbasan O, Bayezid �. Surgical Repair of a Pseudoaneurysm of the Ascending Aorta to Pulmonary Artery Fistula after Replacement of the Ascendan Aorta and Aortic Valve. Clin Surg. 2017; 2: 1534.