title: [Rupture of a chronic dissecting giant aneurysm into the pulmonary artery; report of a case].
abstract: Aortopulmonary fistula is an extremely rare complication of aortic dissection. We report a case of a chronic dissecting giant aneurysm with an aortopulmonary fistula. A 78-year-old woman experienced sudden onset chest pain and oppression. Chest X-ray showed ascending aortic and left ventricular enlargement and pulmonary congestion. Computed tomography (CT) confirmed the 100 mm ascending aortic aneurysm with dissection and aortopulmonary fistula. Operative repair was performed under profound hypothermic circulatory arrest with selective cerebral perfusion. The proximal and distal end were obliterated using a gelatin-resorcin-formaldehyde tissue glue and reinforced with a Teflon felt circumferential strip. The ascending aorta was replaced by a 30 mm coated Dacron vascular graft and the aortopulmonary fistula was closed with pledgeted vertical mattress suture. Postoperative CT showed a normally functioning vascular implant without any sign of aortopulmonary shunt or pulmonary artery stenosis.
authors.affiliation: Department of Cardiovascular Surgery, Dokkyo Medical University Koshigaya Hospital, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Gon
authors.forename: Soichi
authors.initials: S
authors.lastname: Shioguchi
authors.forename: Mamiko
authors.initials: M
authors.lastname: Cho
authors.forename: Tomoshi
authors.initials: T
authors.lastname: Chiba
authors.forename: Koyu
authors.initials: K
authors.lastname: Tanaka
authors.forename: Ichikatsu
authors.initials: I
authors.lastname: Hata
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Irie
authors.forename: Takao
authors.initials: T
authors.lastname: Imazeki
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications*; D001011:Aorta; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery; D001159:Arterio-Arterial Fistula / Q000209:etiology* / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D011651:Pulmonary Artery