ABSTRACT
We report a case of surgical treatment for idiopathic nonspecific inflammatory aneurysms of the abdominal aorta (AAA) with high-dose steroid therapy. The patient was a 35-year-old man who underwent steroid therapy (30 mg/day prednisolone) for idiopathic nonspecific inflammatory AAA and right common iliac artery aneurysm (CIAA) for 5 months. However, the sizes of the aneurysms were slowly increasing, and they were sacculated types, so surgical replacement was performed. Before the operation we continued to give 30 mg/day prednisolone, because decreasing the medicine made the c-reactive protein (CRP) value rise. Perioperatively the therapy continued, and the postoperative course was uneventful. With appropriate steroid therapy, replacement of idiopathic nonspecific inflammatory aneurysms of the abdominal aorta can be performed. It is also important to follow up the patient from long-term, to monitor for pseudoaneurysms from anastomosis or new aneurysms.
ABSTRACT
We report a case of surgical treatment for pseudoaneurysm 4 years after Patch-and-Glue Repair of left ventricle free wall rupture (LVFWR) due to acute myocardial infarction (AMI) in 2004 in a 74-year-old woman, she had been followed in our hospital. And 2 years later, echocardiography and MRI showed a pseudoaneurysm at the repair spot which was growing very slowly. Since we found a thrombus in the pseudoaneurysm, a redo operation was performed in 2008. The pseudoaneurysm was successfully extirpated, under cardiopulmonary bypass. The infracted area had degenerated to scar tissue and we could suture tightly without worrying about a fissure in the wall. We can use Patch-and-Glue Repair to rescue the LVFWR patients due to AMI in the acute stage because it is possible to remove the pseudoaneurysm in the future, on pseudoaneurysm excision in a firmly infarcted area is possible in the chronic stage.