ABSTRACT
Median sternotomy near an existing tracheostoma risks deep sternal wound infection after cardiac surgery. We present herein a case of acute type A aortic dissection in a patient with a permanent tracheostoma after laryngectomy. Total arch replacement with both frozen elephant trunk and extra-anatomical bypass for supra-aortic trunks was performed through T-shaped partial sternotomy, resulting in recovery without deep sternal wound infection.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Blood Vessel Prosthesis Implantation , Aortic Dissection/diagnostic imaging , Aortic Dissection/surgery , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/methods , Humans , Stents , Sternotomy/methods , Tracheostomy/adverse effects , Treatment OutcomeABSTRACT
Althogh peripheral pulmonary aneurysm is a rare entity, the majority of cases become fatal if left untreated, due to sudden rupture and exsanguination. This emphasizes the need for treatment whenever a diagnosis made. A 81-year-old woman was found to have a coin lesion in the left middle field. Enhanced computed tomography (CT) showed strong staining and pulmonary angiography revealed a saccular dilation of the left A3b branch of the pulmonary artery. Successful embolization of the branch of the pulmonary artery was performed.