title: Surgical Strategy for Thoracic Aortic Pseudoaneurysm with Sternal Adherence.
abstract: A thoracic aortic pseudoaneurysm is a life-threatening complication following thoracic aortic surgery. We describe a surgical strategy for this pseudoaneurysm with a high risk for rupture during median sternotomy. The pseudoaneurysm was distended and widely adherent to the posterior sternum. Elective cardiopulmonary bypass and moderate hypothermia were established, and sternotomy was performed without left ventricle distention or brain ischemia. Total arch replacement was successful and the patient was discharged on post operative day (POD) 18. A key surgical strategy was to avoid ventricular fibrillation before sternotomy. Appropriate sternotomy timing and perfusion strategy are crucial for successful treatment.
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Iida
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Misumi
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
keywords: aneurysm; aortic arch; reoperation