title: Analysis of postsurgical aortic false aneurysm in 27 patients.
abstract: Aortic false aneurysm is a rare complication after cardiac surgery. In recent years, improved results have been reported in regard to the surgical management of these high-risk lesions. We retrospectively examined 28 consecutive cases (in 27 patients) of postsurgical aortic false aneurysm diagnosed at our institution from May 1999 through December 2011. Twenty-four patients underwent reoperation. Cardiopulmonary bypass was instituted before sternotomy in 15 patients (63%). Isolated repair of the aortic false aneurysm was performed in 15 patients. Four patients (including one who had already undergone repeat false-aneurysm repair) declined surgery in favor of clinical monitoring. Eleven patients were asymptomatic at the time of diagnosis. In the other 16, the main cause was infection in 7, and previous operation for acute aortic dissection in 9. The in-hospital mortality rate was 16.6% (4 patients, 3 of whom had infective false aneurysms). Relevant postoperative sequelae were noted in 7 patients (29%). The cumulative 1-year and 5-year survival rates were 83% and 62%, respectively. The 4 patients who did not undergo reoperation were alive at a median interval of 23 months (range, 9-37 mo). Two underwent imaging evaluations; in one, computed tomography revealed an 8-mm increase of the false aneurysm's maximal diameter at 34 months. Aortic false aneurysm can develop silently. Surgical procedures should be proposed even to asymptomatic patients because of the unpredictable evolution of the condition. Radical aortic-graft replacement should be chosen rather than simple repair, because recurrent false aneurysm is possible.
authors.affiliation: Department of Cardiac Surgery, IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Italy. pmalvin@tin.it
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Malvindi
authors.forename: Antioco
authors.initials: A
authors.lastname: Cappai
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Raffa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Barbone
authors.forename: Alessio
authors.initials: A
authors.lastname: Basciu
authors.forename: Enrico
authors.initials: E
authors.lastname: Citterio
authors.forename: Diego
authors.initials: D
authors.lastname: Ornaghi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarelli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Settepani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D001027:Aortography / Q000379:methods; D058070:Asymptomatic Diseases; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002315:Cardiopulmonary Bypass; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D056346:Sternotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aortic aneurysm, thoracic/diagnosis/etiology/mortality/prevention&control/radiography/surgery; cardiac surgical procedures/adverse effects; postoperative complications/etiology; recurrence; reoperation/utilization
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