Rupture of a dissecting thoracic aortic aneurysm into the pulmonary artery: successful surgical repair.
A rare complication of dissecting thoracic aortic aneurysms is rupture into a cardiac chamber or great vessel with fistula formation. A case of congestive heart failure caused by a chronic DeBakey type I dissecting aortic aneurysm that ruptured into the pulmonary artery is reported. Surgical repair involved closure of the fistula followed by graft replacement of the ascending aorta and transverse aortic arch. A review of the literature revealed no previous reports describing successful repair of this lesion. A clinical picture consistent with concomitant aortic dissection and biventricular heart failure, especially when a continuous cardiac murmur is present, suggests the diagnosis of an aortopulmonary arterial fistula caused by a ruptured dissecting thoracic aortic aneurysm. Various imaging studies confirm the diagnosis.
Coselli
J S
JS
Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
LeMaire
S A
SA
van Cleve
G D
GD
D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications / Q000601:surgery*; D001159:Arterio-Arterial Fistula / Q000209:etiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities / Q000601:surgery*