J Thorac Cardiovasc Surg 2010;139:e62-e63
© 2010 The American Association for Thoracic Surgery
False aneurysm with aortopulmonary shunt after replacement of the ascending aorta
Wilko Reents, MDa,*,
Werner Kenn, MDb,
Jörg Babin-Ebell, MDc,
Rainer G. Leyh, MD, PhDa,
Armin Gorski, MDa
a Department of Cardiothoracic Surgery, University Hospital Würzburg, Würzburg, Germany
b Department of Radiology, University Hospital Würzburg, Würzburg, Germany
c Department of Cardiovascular Surgery, Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany
Received for publication September 22, 2008; accepted for publication November 19, 2008.
* Address for reprints: Wilko Reents, MD, Department of Cardiothoracic Surgery, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany. (Email: firstname.lastname@example.org).
|The first 20% of the full text of this article appears below.|
The development of a false aneurysm with an aorto-pulmonary shunt is an extraordinary, uncommon, and life-threatening condition. Surgical repair is inevitable, yet the operative approach is hampered by several pitfalls. This report describes the tailored surgical treatment of a mediastinal oseudoaneurysm with an aorto-pulmonary shunt arising after ascending aortic replacement.
Five years after supracoronary replacement of the ascending aorta for acute aortic dissection, a 61-year-old woman had new-onset, rapidly progressive dyspnea. At presentation, she had orthopnea and peripheral edema. Auscultation revealed a continuous diastolic-systolic murmur and diminished basilar breath sounds. Chest radiography showed bilateral pleural effusions and interstitial fluid accumulation. Echocardiography demonstrated a moderate aortic valve insufficiency with prolapse of the right coronary cusp, a periaortic fluid accumulation, and the presence of a shunt between the ascending aorta and the pulmonary artery. Magnetic resonance imaging confirmed the presence of an aortopulmonary shunt (pulmonary/systemic perfusion ratio of 1.89) and demonstrated a large false aneurysm with extravasation of contrast media at the level of . . . [Full Text of this Article]
Copyright © 2010 by The American Association for Thoracic Surgery.