Pseudoaneurysm fistulated into the right atrium after double valve replacement.
We discuss a rare case of an ascending aorta pseudoaneurysm fistulating into the right atrium following prior aortic and mitral valve replacement. Transthoracic echocardiography and computed tomography revealed a pseudoaneurysm of the ascending aorta attached to the right atrium with fistulous communication. The pseudoaneurysm arose from the center of the former aortotomy. Emergency remedian sternotomy was performed without aneurysmal injury and with exposure of the left femoral artery and femoral vein. Aneurysmal resection and ascending aorta repair were performed without complication. Exposing peripheral vessels, and initiating cardiopulmonary bypass only after reentry, might be effective in resternotomy to approach ascending aorta pseudoaneurysms.
Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Hiromu
H
Kehara
Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Tamaki
T
Takano
Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumto, Japan.
Kazunori
K
Komatsu
Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Takamitsu
T
Terasaki
Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumto, Japan.
Kenji
K
Okada
D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001011:Aorta / Q000000981:diagnostic imaging; D001159:Arterio-Arterial Fistula / Q000209:etiology* / Q000601:surgery*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male