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Eur J Cardiothorac Surg 2008;33:1146-1147. doi:10.1016/j.ejcts.2008.03.016
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.

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Masahiro Sakurai
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Case reports

Conservative treatment for rupture of thoracic aortic aneurysm

Asako Namai, Masahiro Sakurai*

Department of Cardiovascular Surgery, National Hospital Organization Sendai Medical Center, 2-8-8, Miyagino, Miyagino-ku, Sendai 983-8520, Japan

Received 31 October 2007; received in revised form 5 March 2008; accepted 14 March 2008.

* Corresponding author. Tel.: +81 22 293 1111; fax: +81 22 291 8114. (Email: sakuraim{at}snh.go.jp).

We present a case of an 88-year-old female with a history of tuberculosis, who was transferred to our hospital due to the sudden onset of epigastralgia and back pain. A chest X-ray demonstrated a bilateral shadow of the upper lung, which suggested the history of tuberculosis. A computed tomography scan demonstrated a large amount of hematoma from the neck to mediastinum and leakage of contrast medium around the distal aortic arch. We diagnosed rupture of thoracic aortic aneurysm, and selected conservative treatment. The patient was intubated under sedation and blood pressure was controlled with vasodepressors. The patient was completely off the ventilator after 65 days of disease, and the patient was discharged after 4 months. This is the first successful case of conservative therapy for ruptured thoracic aortic aneurysm.

Key Words: Rupture of thoracic aortic aneurysm • Tuberculosis • Conservative treatment




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Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.