[Rupture of a chronic dissecting giant aneurysm into the pulmonary artery; report of a case].
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.
Gon
Shigeyoshi
S
Department of Cardiovascular Surgery, Dokkyo Medical University Koshigaya Hospital, Japan.
Shioguchi
Soichi
S
Cho
Mamiko
M
Chiba
Tomoshi
T
Tanaka
Koyu
K
Hata
Ichikatsu
I
Irie
Yoshihito
Y
Imazeki
Takao
T
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