title: Contained rupture of a pseudoaneurysm of the descending thoracic aorta related to remnant outflow graft of left ventricular assist device after heart transplantation.
abstract: The Jarvik 2000 left ventricular assist device is inserted via a left thoracotomy with the outflow graft anastomosed to the descending thoracic aorta. Removal of the device during heart transplantation involves division of the outflow graft, resulting in a retained remnant. We describe the first reported case of a mycotic pseudoaneurysm of the descending thoracic aorta related to the remnant of a left ventricular assist device outflow graft in an immunosuppressed heart recipient complicated with systemic Pseudomonas infection. The pseudoaneurysm was temporarily treated with endovascular stent grafting followed by delayed thoracotomy, pseudoaneurysm excision, and placement of an aortic interposition graft using an aortic allograft.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA. kyamane777@yahoo.co.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamane
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Bogar
authors.forename: Paul J
authors.initials: PJ
authors.lastname: DiMuzio
authors.forename: Scott W
authors.initials: SW
authors.lastname: Cowan
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirose
authors.forename: Nathaniel R
authors.initials: NR
authors.lastname: Evans
authors.forename: Atul S
authors.initials: AS
authors.lastname: Rao
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Eisenberg
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Cavarocchi
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods; D014694:Ventricular Outflow Obstruction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery