HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Fernando A. Atik Jose L. Navia Lars G. Svensson Pablo Ruda Vega Mariano E. Brizzio Eugene H. Blackstone Bruce W. Lytle Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Atik, F. A. Articles by Lytle, B. W. Search for Related Content PubMed PubMed Citation Articles by Atik, F. A. Articles by Lytle, B. W. Related Collections Great vessels

J Thorac Cardiovasc Surg 2006;132:379-385
© 2006 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Surgical treatment of pseudoaneurysm of the thoracic aorta

^a Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio
^b Department of Quantitative Health Sciences, The Cleveland Clinic Foundation, Cleveland, Ohio

Received for publication November 11, 2005; revisions received February 24, 2006; accepted for publication March 8, 2006.

^_* Address for reprints: Jose L. Navia, MD, The Cleveland Clinic Foundation, Department of Thoracic and Cardiovascular Surgery, 9500 Euclid Ave/F24, Cleveland, OH 44195. (Email: naviaj{at}ccf.org).

OBJECTIVES: To examine the clinical profiles, operative outcomes, and late results of patients with pseudoaneurysm of the thoracic aorta.

METHODS: From 1990 to 2002, 60 patients underwent repair of aortic pseudoaneurysm: ascending aorta in 70%, ascending aorta and arch in 15%, descending aorta in 10%, and arch alone in 5%. Mean age was 53 ± 15 years, and 70% were men. Of these, 50 (83%) had undergone previous cardiac surgery, including 22 (37%) composite valve graft operations. The preferred cannulation site was femoral-femoral (n = 27, 45%), with deep hypothermic circulatory arrest in 62% and retrograde cerebral perfusion in 33%; more recently, however, axillary cannulation has been preferred.

RESULTS: Principal etiologies were graft infection in ascending aorta pseudoaneurysm and trauma in descending aorta pseudoaneurysm. Fifteen patients (25%) presented with chest pain, 13 (22%) with heart failure, and 20% with moderate or severe aortic regurgitation. The pseudoaneurysm was resected and the aorta replaced (n = 45, 75%) or repaired (n = 15, 25%) using various methods. Hospital mortality was 6.7% (n = 4). Reexploration for bleeding was required in 8.3%, and 3.3% had postoperative stroke. At 30 days, 5 years, and 10 years, survival was 94%, 74%, and 60% and freedom from reoperation was 95%, 77%, and 67%, respectively.

CONCLUSIONS: Most patients with aortic pseudoaneurysm require ascending aorta and/or arch replacement, which can be accomplished with low operative mortality and morbidity. Long-term survival and freedom from reoperation in these young patients parallel those expected for complex cardiac and aortic disease.

This article has been cited by other articles:

				A. Emaminia, A. A. Amirghofran, M. Shafa, A. Moaref, and R. Javan Ascending aortic pseudoaneurysm after aortic valve replacement: Watch the tip of the cardioplegia cannula! J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1285 - 1286. [Full Text] [PDF]

				P. Rispoli, G. Varetto, F. M. Savia, and M. Rinaldi Large post-stenting innominate artery pseudoaneurysm Interactive CardioVascular and Thoracic Surgery, June 1, 2008; 7(3): 444 - 446. [Abstract] [Full Text] [PDF]

				O. Cohen, J. Odim, D. De La Zerda, C. Ukatu, R. Vyas, N. Vyas, K. Palatnik, and H. Laks Long-Term Experience of Girdling the Ascending Aorta With Dacron Mesh as Definitive Treatment for Aneurysmal Dilation Ann. Thorac. Surg., February 1, 2007; 83(2): S780 - S784. [Abstract] [Full Text] [PDF]