Pseudoaneurysm of the Ascending Aorta after Cardiovascular Surgery / 日本心臓血管外科学会雑誌

ABSTRACT

Pseudoaneurysm of the ascending aorta is a rare but potentially fatal complication of cardiovascular surgery. Two cases are described in which a pseudoaneurysm of the ascending aorta developed and caused profuse intermittent bleeding through the MRSA infection of the sternotomy wound. One was a 29-year-old man who had undergone a mitral valve replacement five months previously. The aneurysm was successfully repaired with a prosthetic graft patch under deep hypothermia and circulatory arrest, when a bloodless field was obtained using a handmade double-balloon catheter. The other patient was a 79-year-old man who had undergone a graft replacement of the distal aortic arch four months previously. The possibility of surgical correction was also considered but was thought to carry too high a risk. Embolization of the aneurysm was therefore regarded as the only realistic alternative, but failed, and he died due to aneurysmal rupture. The importance of the diagnosis process and surgical and intervascular treatment of pseudoaneurysm of the ascending aneurysm is described.