RESUMO
BACKGROUND: High mortality and morbidity rates are associated with the conventional surgery for aortic arch aneurysm because of cardiopulmonary bypass and deep hypothermic circulatory arrest. In this report, we describe a "hybrid" treatment for aortic arch aneurysm that combines the surgical debranching procedure and the stenting technique. METHODS: A surgical bypass graft is created from the ascending aorta to every main branch of the aortic arch. Subsequently, an endovascular stent graft is deployed retrogradely through the femoral artery with the aid of digital subtraction angiography. RESULT: The patient was discharged on postoperative day 7. A computed tomography scan was routinely performed at 1 week postoperatively to confirm the good patency of all grafts and the stent. CONCLUSION: The feasibility and the benefit of the hybrid treatment for aortic arch aneurysm are confirmed.
Assuntos
Aorta Torácica/cirurgia , Aneurisma Aórtico/cirurgia , Prótese Vascular , Stents , Enxerto Vascular/instrumentação , Enxerto Vascular/métodos , Aneurisma Aórtico/diagnóstico , Terapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Ruptured sinus of Valsalva aneurysm is a rare but well recognized clinical entity. These patients develop congestive heart failure due to biventricular increases in volume as a result of sudden aortocardiac shunting. Traditionally, surgical repair has been the mainstay of therapy. We report a case of a ruptured sinus of Valsalva aneurysm that was successfully closed percutaneously using the Amplatzer duct occluder in a critically ill patient operated on previously for coronary artery disease and presenting with acute congestive heart failure.
