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Vol 24, No 1-2 (2022)
Case report
Published online: 2023-06-27

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Aortic pseudoaneurysm in a patient after Bentall de Bono surgery

Michał Wysocki1, Weronika Biziorek1, Łukasz Moskal1, Katarzyna Wijatkowska1, Wojciech Kustrzycki1, Romuald Cichoń1
Chirurgia Polska 2022;24(1-2):36-39.

Abstract

Pseudoaneurysm is an aneurysm arising as a result of rupture with all layers of the artery wall. It differs from the true aneurysm in the wall structure, aetiology, complications and indications for invasive treatment. Postoperative pseudoaneurysms of the thoracic aorta are rare complications, but extremely dangerous and life-threatening. Therefore, it is important to keep in mind crucial factors that can lead to its appearance. The method of treatment depends on localization with median sternotomy in the surgical approach to a pseudoaneurysm of the ascending aorta. Most frequently surgeons excise the aneurysm and sew appropriate prosthesis in the place of the excision. As a result, the Bentall de Bono procedure is widely used, when the aortic root replacement is required. This study presents a case of a 59-year-old man with a huge pseudoaneurysm of the ascending aorta 3.5 months after the Bentall de Bono operation. The patient’s treatment included resternotomy with the use of a similar technique once again. EuroScore II was high and amounted to 21.94%. Additionally, hypothermia was used to increase the effectiveness of the procedure, i.e. to minimalize blood loss, protect the central nervous system from the risk of ischaemia and facilitate the patient’s recovery. Pseudoaneurysm can develop for years without any symptoms, and its rupture can be fatal. Finally, detection and removal of the lesion at the beginning of its formation has a positive impact on the patient’s prognosis.

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Chirurgia Polska (Polish Surgery)