title: [A case report of ruptured pseudoaneurysm into the left lung after graft replacement of the descending thoracic aorta].
abstract: We report a successful case of total aortic arch replacement using selective cerebral perfusion for ruptured pseudoaneurysm into the left lung after graft replacement of the descending thoracic aorta. A 74-year-old female who had graft replacement of the descending thoracic aorta for ruptured acute type B dissecting aneurysm into the left pleural cavity was admitted with a complaint of severe hemoptysis. Preoperative enhanced computed tomography revealed a large pseudoaneurysm of the aortic arch and massive hematoma around it. She was diagnosed as having a ruptured pseudoaneurysm into the left lung. A graft replacement of the total aortic arch with the aid of selective cerebral perfusion was performed. At the time of operation, a pseudoaneurysm which was from an intimal defect in the aortic wall 2 cm proximal to the suture line was found. It was suspected that the cause of the pseudoaneurysm was due to clamp injury during the initial operation. Postoperatively, she had no cerebral complications, and digital subtraction angiography showed excellent reconstruction of the aortic arch. One month after the operation, she had recovered sufficiently to be discharged from our hospital.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koshino
authors.forename: T
authors.initials: T
authors.lastname: Kazui
authors.forename: Y
authors.initials: Y
authors.lastname: Tamiya
authors.forename: J
authors.initials: J
authors.lastname: Fukada
authors.forename: R
authors.initials: R
authors.lastname: Koushima
authors.forename: T
authors.initials: T
authors.lastname: Abe
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000209:etiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000209:etiology* / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008168:Lung; D011183:Postoperative Complications / Q000601:surgery*