1/192. Chronic traumatic aortic pseudoaneurysm: resolution with observation.Immediate operative repair is the most commonly recommended treatment for traumatic aortic ruptures, regardless of age or size of the lesion. We report a patient who presented with a large chronic aortic pseudoaneurysm and has been thus far managed nonoperatively with shrinkage of his lesion and no symptoms.- - - - - - - - - - ranking = 1keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
2/192. Observations on the treatment of dissection of the aorta.The results are presented of treatment in twenty-three patients with dissection of the thoracic aorta, in four of whom it was acute (less than 14 days' duration), and in nineteen chronic (more than 14 days' duration). Sixteen patients had Type I and II dissection (involving the ascending aorta) and five Type III (descending aorta at or distal to the origin of the left subclavian artery); in two, dissection complicated coarctation of the aorta in the usual site. Thirteen patients had aortic regurgitation. Three of the patients with acute dissection were treated medically; two, both with Type I dissection, died, and the third, with Type III, survived. The remaining acute patient was treated surgically and also died. Of the patients with chronic dissection, eight were treated medically and eleven surgically. None of the medical group died in hospital; three died between 3 months and 1 year, and five have survived from periods of 12-72 months. Eleven patients with chronic dissection were treated surgically; four died in hospital at or shortly after operation; and the remaining seven lived for periods of 12-84 months. The presentation, indications for surgical treatment and results are discussed. It is concluded that surgical treatment of chronic dissection may carry a higher initial mortality than medical, but that there may be slightly better overall long term results in the former. As this series was not selected randomly, because patients with complications were selected for surgery, and there are only a few patients in each group, the results do not permit firm conclusion regarding the relative merits of medical and surgical treatment. It is suggested that all patients should initially be treated medically but that surgical treatment should be considered if the dissection continues, if aortic regurgitation is severe, if an aneurysm develops or enlarges, if cardiac tamponade develops or there is evidence of progressive involvement of the branches of the aorta. attention is drawn to the important syndrome of chronic dissecting aneurysm of the ascending aorta with severe aortic regurgitation which requires definitive surgical treatment and aortic valve replacement. The importance of adequate visualization of the origin and extent of the dissection as a preliminary to surgical treatment is stressed.- - - - - - - - - - ranking = 0.12078048338593keywords = aneurysm (Clic here for more details about this article) |
3/192. Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis.A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.- - - - - - - - - - ranking = 0.42273169185077keywords = aneurysm (Clic here for more details about this article) |
4/192. Repair of abdominal aortic aneurysm in severe factor vii deficiency.Congenital factor vii deficiency is a rare disorder associated with reduced levels of Factor VII activity. Replacement therapy is necessary to control hemorrhaging or if surgery is needed. We report operative treatment of one case of chronic abdominal aortic aneurysm in a patient affected by a severe form of congenital factor vii deficiency (endogenous FVII level <1%). The operation was carried out after the administration of Factor VII concentrate raised the Factor VII concentration to hemostatic levels. The patient continued to receive the concentrate every 6 hrs during the first three postoperative days. Dosage was assessed to obtain Factor VII levels not lower than 25%. No postoperative bleeding or thrombotic events were observed. The patient was discharged in excellent condition.- - - - - - - - - - ranking = 0.30195120846483keywords = aneurysm (Clic here for more details about this article) |
5/192. Ischemic colitis with chronic stenotic evolution.The authors describes a case of ischemic chronic stenosis of colon after aneurysmectomy. They consider eziopatogenesis, clinical aspects and differential diagnosis with other causes of large bowel stenosis. They illustrate on therapeutic sequence after examination of recent literature.- - - - - - - - - - ranking = 0.060390241692967keywords = aneurysm (Clic here for more details about this article) |
6/192. Chronic haemoptysis as delayed complication of ventricular aneurysmectomy.Two patients developed a ventriculo-pulmonary fistula several years after original resection of a left ventricular aneurysm. Both presented with chronic mild haemoptysis. In the first case mild haemoptysis lasted nearly 19 months, and despite a battery of non invasive and invasive investigations, diagnosis was ultimately made via exploratory thoracotomy. In the second case mild haemoptysis lasted four months and finally manifested as a large haemoptysis. diagnosis was made preoperatively using echocardiography. We recommend the use of echocardiography when haemoptysis occurs in a patient with a previous history of ventricular aneurysm repair.- - - - - - - - - - ranking = 0.3623414501578keywords = aneurysm (Clic here for more details about this article) |
7/192. Chronic sternal wound infection and endocarditis with coxiella burnetii.Chronic q fever is most commonly associated with culture-negative endocarditis and less frequently with infection of vascular grafts, infection of aneurysms, hepatitis, pulmonary disease, osteomyelitis, and neurological abnormalities. We report a case of chronic sternal wound infection, polyclonal gammopathy, and mixed cryoglobulinemia in which q fever endocarditis was subsequently diagnosed. polymerase chain reaction analysis of the wound tissue was positive for Coxiella burnetii dna, and treatment of the endocarditis resulted in prompt healing of the wound. Chronic q fever can occur without epidemiological risk factors for C. burnetii exposure and can produce multisystem inflammatory dysfunction, aberrations of the immune system, and persistent wound infections.- - - - - - - - - - ranking = 0.060390241692967keywords = aneurysm (Clic here for more details about this article) |
8/192. Spontaneous thrombosis of a pseudoaneurysm complicating pancreatitis.patients with a visceral aneurysm are at high risk for acute transpapillary, intra-, or retroperitoneal hemorrhage, necessitating either surgical or endovascular therapy. We report an instance of spontaneous thrombosis of a pseudoaneurysm complicating pancreatitis before endovascular treatment could be performed. causality and the literature of spontaneous thrombosis in pseudoaneurysms are discussed.- - - - - - - - - - ranking = 1.260390241693keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
9/192. Massive tracheal necrosis due to compression by an innominate artery aneurysm associated with a grade IV Chagasic megaesophagus and chronic duodenal ulcer.A 49-year-old man suffered necrosis of the cephalad tracheal segment due to compression by an innominate artery aneurysm. A peritracheal abscess, a grade IV chagasic megaesophagus, and a duodenal ulcer were also present. The patient underwent a three-stage surgical treatment, and 7 years later he is doing well, and breathing and eating normally.- - - - - - - - - - ranking = 0.30195120846483keywords = aneurysm (Clic here for more details about this article) |
10/192. Chronic Chagas' heart disease in a Japanese-Brazilian traveler. A case report.A 57-year-old Japanese-Brazilian man, visiting japan for only 9 days, was admitted to our hospital due to syncope and frequent ventricular premature beats. He grew up in a rural area of brazil and moved to Sao Paulo in 1959 when he was 20 years old. We suspected chronic Chagas' heart disease, i.e., dilated cardiomyopathy with apical ventricular aneurysm, right bundle branch block with left anterior fascicular block, and various arrhythmias including supraventricular premature beats, ventricular premature beats and non-sustained ventricular tachycardia because he showed typical echo- and electrocardiographic features of the disease. Coronary arteriograms were normal, and left ventriculogram confirmed the existence of apical ventricular aneurysm. A left ventricle biopsy specimen showed hypertrophic cardiac muscle with mild fibrosis. The diagnosis of chronic Chagas' disease was finally confirmed by the demonstration of trypanosoma cruzi itself in the blood as well as trypanosoma cruzi antibodies.- - - - - - - - - - ranking = 0.12078048338593keywords = aneurysm (Clic here for more details about this article) |
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