Eur J Cardiothorac Surg 2001;20:847
© 2001 Elsevier Science NL
Images in cardio-thoracic surgery |
False aneurysm of ascending aorta-anastomosis after orthotopic heart transplantation
Stefan Klotza,
Dieter Hammela,
Christoph Schmidtb,
Hans H. Schelda
a Department of Cardiothoracic Surgery, Muenster University Hospital, Muenster, Germany
b Department of Anaesthesiology and Intensive Care, Muenster University Hospital, Muenster, Germany
Received 31 March 2001;
received in revised form 25 June 2001;
accepted 28 June 2001.
Corresponding author. Tel.: +49-251-8347401; fax: +49-251-8348316
Key Words: Transplantation • Thoracic aneurysm • Anastomosis • Hypothermic circulatory arrest
We operated a 49-year-old man 4 years after orthotopic heart-transplantation with a false aneurysm due to a 2 cm dehiscence between the anastomosis of the recipient and donor ascending aorta (Fig. 1
). Prior to transplantation, the patient was bridged with a Novacor-LVAD due to ischemic cardiomyopathy. There were no signs of infection during LVAD-explant. The partly thrombosed aneurysm was treated by interposition of a 22-mm-dacron tube-graft with reinsertion of the brachiocephalic truncus using a 10-mm-dacron-prothesis under CBP and hypothermic circulatory arrest. We find no aspects for a mycotic aneurysm. The reason was probably a slowly acquiring post-transplant arterial hypertension. At postoperative day (POD) 20, the patient was discharged after uneventful postoperative course. Postoperative CT-scans showed regular anastomosis (Fig. 2 ).
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Fig. 1. Preoperative CT-scan with the partly thrombosed false aneurysm (9 cm in diameter) with sternal erosion (white arrow).
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Fig. 2. Postoperative CT-scan with the 22-mm dacron tube graft (long black arrow) and the 10-mm-dacron-prothesis for reinsertion of the brachiocephalic truncus (small black arrow).
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