Giant anastomotic pseudoaneurysm complicating aortic xenograft replacement.
A 74-year-old woman was referred for investigation of a 2-week history of progressive dyspnea. Her medical history included an aortic valve replacement with a stentless bioprosthesis followed 13 months later by the replacement of the aortic root with a porcine xenograft. Transesophageal echocardiography revealed a giant circular pseudoaneurysm of the aortic xenograft with compression of the prosthetic aortic valve and concomitant severe aortic regurgitation. Dehiscence of the proximal graft anastomosis was also diagnosed, and a possible distal anastomotic dehiscence was suspected. The latter turned out intraoperatively to be an almost complete dehiscence of the right coronary artery. The patient died intraoperatively.
Kucher
Nils
N
Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland.
Kipfer
Beat
B
Seiler
Christian
C
Allemann
Yves
Y
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D012086:Reoperation