Ascending Aortic Aneurysm after Aortic and Mitral Valve Replacement. Probably Dissecting Rather than Pseudoaneurysm / 日本心臓血管外科学会雑誌

ABSTRACT

A 53-year-old man underwent aortic and mitral valve replacement, but postoperative cardioangiograms unexpectedly demonstrated aneurysms that had developed right-anteriorly and exactly anteriorly to the ascending aorta. They were initially thought to be pseudoaneurysms formed at the sites of aortotomy for valve replacement and of the aortic hole made by the needle puncture for air-venting. Operative findings, however, strongly suggested that it was a DeBakey type II dissecting aneurysm with two entries at the same sites as described. It was found that almost all distal parts of the aneurysmal cavity, probably a pseudolumen, had been occluded with clots, leaving two round cavities at the entries, which were preoperatively observed as pseudoaneurysms. The entries were successfully closed with approximation of the aortic walls using cardiopulmonary bypass, and the patient survived the operation.