Eur J Cardiothorac Surg 2002;21:760
© 2002 Elsevier Science NL
Images in cardio-thoracic surgery |
Descending aortic aneurysm following ascending to descending bypass in the treatment of aortic re-coarctation
T. Carrel*,
P. Berdat
Clinic for Cardiovascular Surgery, University Hospital, Freiburgstrasse, CH-3010 Berne, Switzerland
Received 26 November 2001;
accepted 7 January 2002.
* Corresponding author. Tel.: +41-27-723-6171; fax: +41-27-723-6173
e-mail: thierry.carrel{at}insel.ch
A 23-year-old female patient was referred because of hemoptysis. She had had aortic coarctation repair with a prosthetic patch at the age of 6 years. Eight years later an ascending to descending bypass was performed because of re-coarctation.
At admission, she presented with a large pseudoaneurysm at the distal anastomosis (Fig. 1)
and was suspected to suffer from aorto-bronchial fistula. Operative repair was performed under femoro-femoral bypass and consisted in ligation of the hypoplastic aortic arch, exclusion of the aneurysm with a Vaskutek Anteflow (Sulzer, Switzerland) vascular graft, the side-arm being used to repair the left subclavian artery (white arrow in Fig. 2)
. Postoperative recovery was uneventful.
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Fig. 1. Angiography demonstrating the large pseudoaneurysm at the distal anastomotic site between the graft and the descending aorta.
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Fig. 2. Postoperative Angio-CT showing the normal configuration after graft interposition and reconstruction of the left subclavian artery with the side-arm of the vascular graft. Note that the hypoplastic aortic arch has been ligated.
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