Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Aortic Pseudo aneurysm 3 Years after Interposition Tube Graft for Acute Dissection of Ascending Aorta

Document Type : Case Report

Authors
Aliasghar Moeinipour 1
Mohammad Abbassi Teshnisi 1
Mohamadreza Akbari 2
Kayhan Mizani 3
Mahsa Moallemi 3
Omid Javdanfar 4
Hamid Hoseinikhah 1
1 Cardiac Surgeon, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 General Physician, Faculty of medical science, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Resident of Cardiac Surgery, Department of Cardiac Surgery, Faculty of Medical Science, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/jctm.2019.40342.1225
Abstract
Introduction:
Patients with primary acute aortic dissection are at higher risk of complications, including increasing aortic aneurysm diameter, aortic rupture, aortic pseudo aneurysm, and recurrent aortic dissection.
Case presentation
We presented the case of a recurrent pseudo aneurysm and rupture of the aorta in the distal ascending aorta and proximal arch 3 years after the initial procedure for acute aortic dissection. The patient had bleeding from previous skin incision. In computed tomography angiography, the site of rupture of the aorta and abnormal communication with sternum were confirmed.
Conclusion
Recurrent aortic dissection is a catastrophic event and has high mortality; however, it is rare and is treated in a short time by redo surgery.
Keywords
Aortic Dissection
Aortic Pseudoaneurysm
Cardiac Surgery
  1. van de Laar IM, Oldenburg RA, Pals G, Roos-Hesselink JW, de Graaf BM, Verhagen JM, et al. Mutations in SMAD3 cause a syndromic form of aortic aneurysms and dissections with early-onset osteoarthritis. Nat Genet. 2011; 43:121-6.
  2. Aubart M, Gobert D, Aubart-Cohen F, Detaint D, Hanna N, d’Indya H, et al. Early-onset osteoarthritis, Charcot-Marie-Tooth like neuropathy, autoimmune features, multiple arterial aneurysms and dissections: an unrecognized and life threatening condition. PLoS One. 2014; 9:e96387.
  3. Moosavi-Movahedi AA, Golchin AR, Nazari KK, Chamani J, Saboury AA, Bathaie SZ, et al. Microcalorimetry, energetics and binding studies of DNA–dimethyltin dichloride complexes. Thermochim Acta. 2004; 414:233-41.
  4. Kirsch M, Legras A, Bruzzi M, Louis N. Fate of the distal aorta after surgical repair of acute DeBakey type I aortic dissection: a review. Arch Cardiovasc Dis. 2011; 104:125-30.
  5. Halstead JC, Meier M, Etz C, Spielvogel D, Bodian C, Wurm M, et al. The fate of the distal aorta after repair of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2007; 133:127-35.
  6. Zierer A, Voeller RK, Hill KE, Kouchoukos NT, Damiano RJ Jr, Moon MR. Aortic enlargement and late reoperation after repair of acute type A aortic dissection. Ann Thorac Surg. 2007; 84:479-86.
  7. Zolfagharzadeh M, Pirouzi M, Asoodeh A, Saberi MR, Chamani J. A comparison investigation of DNP-binding effects to HSA and HTF by spectroscopic and molecular modeling techniques. J Biomol Struct Dyn. 2014; 32:1936-52.
  8. Kim JB, Kim K, Lindsay ME, MacGillivray T, Isselbacher EM, Cambria RP, et al. Risk of rupture or dissection in descending thoracic aortic aneurysm. Circulation. 2015; 132:1620-9.
  9. Ptaszek LM, Kim K, Spooner AE, MacGillivray TE, Cambria RP, Lindsay ME, et al. Marfan syndrome is associated with recurrent dissection of the dissected aorta. Ann Thorac Surg. 2015; 99:1616-23.
  10. Rylski B, Bavaria JE, Beyersdorf F, Branchetti E, Desai ND, Milewski RK, et al. Type A aortic dissection in Marfan syndrome: extent of initial surgery determines long-term outcome. Circulation. 2014; 129:1381-6.
  11. Isselbacher EM, Bonaca MP, Di Eusanio M, Froehlich J, Bassone E, Sechtem U, et al. Recurrent aortic dissection: observations from the international registry of aortic dissection. Circulation. 2016; 134:1013-24.
  12. Schoenhoff FS, Jungi S, Czerny M, Roost E, Reineke D, Matyas G, et al. Acute aortic dissection determines the fate of initially untreated aortic segments in Marfan syndrome. Circulation. 2013; 127:1569-75.
  13. Chamani J, Heshmati M. Mechanism for stabilization of the molten globule state of papain by sodium n-alkyl sulfates: spectroscopic and calorimetric approaches. J Colloid Interface Sci. 2008; 322:119-27.
  14. Leshnower BG, Chen EP. When and how to replace the aortic root in type A aortic dissection. Ann Cardiothorac Surg. 2016; 5:377-82.
  15. Dell'Aquila AM, Concistre G, Gallo A, Pansini S, Piccardo A, Passerone G, et al. Fate of the preserved aortic root after treatment of acute type A aortic dissection: 23-year follow-up. J Thorac Cardiovasc Surg. 2013; 146:1456-60.
  16. Halstead JC, Spielvogel D, Meier DM, Rinke S, Bodian C, Malekan R, et al. Composite aortic root replacement in acute type A dissection: time to rethink the indications? Eur J Cardiothorac Surg. 2005; 27:626-32.
  17. Lai DT, Miller DC, Mitchell RS, Oyer PE, Moore KA, Robbins RC, et al. Acute type A aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair. J Thorac Cardiovasc Surg. 2003; 126:1978-86.
Journal of Cardio-Thoracic Medicine
Volume 7, Issue 2
Spring 2019
Pages 453-455