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Eur J Cardiothorac Surg 2008;34:928. doi:10.1016/j.ejcts.2008.07.005
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Letters to the Editor

Reply to Steichen. Survival from ruptured aortic aneurysm without any operations

Masahiro Sakurai*, Asako Namai

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

Received 3 July 2008; accepted 3 July 2008.

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

Key Words: Elderly patient • Conservative treatment • Severe tuberculous adhesion

Steichen suggested that our reported case of aneurysm was not caused by tuberculosis [1]. We have no idea whether our case was tuberculous aortic aneurysm or not because we did not perform an operation and we could not give histopathologic examination. This was not the point of our report.

We did not perform surgery because the patient was elderly (88 years old) and the patient's family selected the conservative treatment. By chance, rupture of thoracic aortic aneurysm, of which mortality is very high [2,3], occurred on the patient who had a history of lung tuberculosis. We believed that the ruptured site might be sealed by the scared tissue, and the patient survived with conservative treatment. There have been some reports that the tuberculous adhesions around aorta or pulmonary cavity were severe in the operation findings [4,5], and we referred those factors. Our case was quite rare.

References

  1. Steichen O. Treatment of ruptured tuberculous aortic aneurysms. Eur J Cardiothorac Surg 2008;34:928.[Free Full Text]
  2. Nienaber CA, Fattori R, Lung G. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Eng J Med 1999;340:1539-1545.[Abstract/Free Full Text]
  3. Dake MD, Kato N, Mitchell RS. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Eng J Med 1999;340:1546-1552.[Abstract/Free Full Text]
  4. Ohtsuka T, Kotsuka Y, Yagyu K, Fukase A, Oka T. Tuberculous pseudoaneurysm of the thoracic aorta. Ann Thorac Surg 1996;62:1831-1834.[Abstract/Free Full Text]
  5. Aebet H, Birnbaum DE. Tuberculous pseudoaneurysms of the aortic arch. J Thorac Cardiovasc Surg 2003;125:411-412.[Free Full Text]




This Article
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Masahiro Sakurai
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Right arrow Articles by Namai, A.
PubMed
Right arrow Articles by Sakurai, M.
Right arrow Articles by Namai, A.
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