RESUMO
Severe atherosclerotic calcification of the ascending aorta, the so-called porcelain aorta, precludes cardiac surgeons from placing an aortic cross-clamp and direct aortic cannulation due to the increased risk of systemic embolism and stroke. In the present report, we support the option of sutureless valve implantation in a case of a porcelain ascending aorta, with deep hypothermic circulatory arrest and also without aortic cross-clamp.
Assuntos
Valva Aórtica/cirurgia , Calcinose/cirurgia , Parada Circulatória Induzida por Hipotermia Profunda/métodos , Implante de Prótese de Valva Cardíaca/métodos , Idoso de 80 Anos ou mais , Aorta/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Aterosclerose/etiologia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Constrição , Feminino , Humanos , Esternotomia , Suturas , Tomografia Computadorizada por Raios XRESUMO
Ruptured Penetrating Ulcer and aortic arch pseudo-aneurysm is a rare condition but one which carries a high risk of rupture. We report the case of a 74-year-old man with aortic arch pseudo-aneurysm, in which a Frozen Elephant Trunk procedure was successfully performed. There were no postoperative complications at 6 months follow-up. The Computed Tomography Angiogram demonstrated thrombus formation in the pseudo-aneurysm lumen, with no endoleak on the stented part of the descending thoracic aorta and complete patency of all branches of aortic arch. This case demonstrates that the Frozen Elephant Trunk technique may be the treatment of choice when treating such complex aortic arch lesions provided there is no absolute contraindication to radical surgical intervention. However, long-term clinical efficacy and safety have yet to be confirmed.
