Innominate artery aneurysm with hemoptysis and airway compression in a patient with bovine aortic arch.
We present the case of a 63-year-old man with a bovine aortic arch variation, who presented episodes of mild hemoptysis secondary to a 4.5-cm (diameter) aneurysm of the innominate artery that compressed the trachea and obliterated the right subclavian artery. Surgery, performed through a median sternotomy, consisted of a bypass from the ascending aorta to both common carotid arteries using a Dacron graft, and exclusion of the aneurysm by ligature and direct thrombin injection. Computed tomography angiography at 30 days showed a patent bypass, successful aneurysm exclusion, and improvement of the tracheal compression. The patient is currently asymptomatic at 12 months following the procedure.
Section of Vascular and Endovascular Surgery, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain. ionstenla@yahoo.es
Iván
I
Constenla
Beatriz
B
Alvarez
Xavier
X
Yugueros
Elisabeth
E
Fernandez
Ramon
R
Bofill
Manel
M
Matas
D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology*; D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery; D017536:Carotid Artery, Common / Q000002:abnormalities / Q000601:surgery; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D015552:Injections, Intralesional; D008026:Ligation; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D013349:Subclavian Steal Syndrome / Q000209:etiology; D013917:Thrombin / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
D013917:Thrombin