ABSTRACT
Flow reversal and thromboexclusion constitute a valuable alternative for aortic surgeons to have within their technical armamentarium for the treatment of aortic aneurysmal disease. Although not usually a preferred treatment for general aortic pathologies, this technique can be considered as a treatment option in select situations, such as mycotic aneurysm, a hostile surgical field, and a poor condition of the patient. Here, we present a case of extra-anatomic bypass and thromboexclusion for recurrent aortic aneurysm after previous extra-anatomic bypass and thromboexclusion surgery.
Subject(s)
Humans , Aneurysm, Infected , Aortic Aneurysm , Pathology , SurgeonsABSTRACT
A 37-year-old female was admitted to our hospital because of haemoptysis. She had undergone descending thoracic aorta-abdominal aorta bypass grafting 11 years previously. Then the diagnosis was atypical coarctation due to aortitis syndrome. No follow up had been continued. Angiogram and CTscan disclosed a false aneurysm at the anastomotic site of the descending thoracic aorta, which was ruptured into the left lung. An emergency operation was performed. A new extra-anatomical ascending aorta abdominal aorta bypass was constructed using 16mm Dacron prosthesis, and three permanent clamps were employed for thromboexclusion of the descending aorta, previous bypass graft and the ruptured aneurysm. At present, three years after the operation, she is leading normal life with medication of hypotensive drugs. Pathogenesis, surgical approach and long-term postoperative care were discussed.