Cases reported "Aortic Aneurysm"

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1/31. Surgical repair of a pseudoaneurysm of the ascending aorta after aortic valve replacement.

    We report the case of a patient with a pseudoaneurysm of the ascending aortic clinically diagnosed 5 months after surgical replacement of the aortic valve. diagnosis was confirmed with the aid of two-dimensional echocardiography and helicoidal angiotomography. The corrective surgery, which consisted of a reinforced suture of the communication with the ascending aorta after opening and aspiration of the cavity of the pseudoaneurysm, was successfully performed through a complete sternotomy using extracorporeal circulation, femorofemoral cannulation, and moderate hypothermia, with no aortic clamping.
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2/31. Aortic root replacement and coronary interposition using a cryopreserved allograft and its branch.

    This communication describes a modified aortic root replacement technique using a cryopreserved allograft consisting of the aortic conduit and its branch. This method was applied in a patient suffering from infective pseudoaneurysm which had developed after aortic root replacement using an artificial graft with a mechanical aortic valve. A piece of the innominate artery obtained from the aortic allograft was used for interposition between the fragile left coronary artery root and the main conduit of the allograft.
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3/31. False aneurysm of the ascending aorta with perforation into the right ventricle presenting as acute inferior myocardial infarction.

    The authors describe the case of a 76-year-old woman who presented with acute inferior myocardial infarction 8 years after prosthetic aortic valve replacement. echocardiography and cardiac catheterization revealed a false aneurysm of the ascending aorta with fistulous communication to the right ventricle. The right coronary artery originated from the false aneurysm with no antegrade perfusion.
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4/31. Abdominal aortic aneurysm with aorto-vena caval fistula and retroperitoneal rupture. Report of a case.

    One successfully treated case of ruptured aortic aneurysm with aorto-caval fistula is reported. At admission a large pulsating mass was present in the abdomen, and a prominent continuous bruit was heard by stethoscopy. Surgery revealed an aortic aneurysm with a retroperitoneal rupture and a large aorto-caval communication as well. The fistula was closed with continuous sutures, and after excision of the aneurysm the arterial continuity was re-established using a "Millinit" dacron graft. The postoperative course was uneventful.
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5/31. Repair of tuberculous aneurysm of distal aortic arch.

    A 65 year old female patient presented with one episode of massive haemoptysis requiring transfusion and subsequently cough with streaky haemoptysis. Computerized tomographic scan and angiogram revealed aneurysm of the distal aortic arch. She underwent elective repair of the pseudoaneurysm through median sternotomy and the bronchial communication was closed through left thoracotomy. Tubercle bacilli were identified in the contents and excised wall of aortic tissue.
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6/31. Recurrent hemoptysis due to aortobronchopulmonary fistula of false aortic aneurysm associated with repair of rupture of the sinus of valsalva.

    A 54-year-old man presented with recurrent hemoptysis of one year duration. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a saccular aneurysm of the ascending aorta. The aneurysm was intraoperatively found to have formed on the superior surface of the site of aortotomy suture placed during previous repair of rupture of the sinus of valsalva and to have a fistulous communication to the lung. CT and MRI were very useful in the diagnosis of the aneurysm as the cause of hemoptysis.
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7/31. Aneurysm of sinus of valsalva dissecting into interventricular septum: a late complication of aortic valve replacement.

    A 43-year-old man who had a Carbomedics prosthetic aortic valve replacement in 1997 was admitted to our hospital with complaints of shortness of breath and dyspnea on exertion in 2000. The patient was hospitalized due to atrioventricular (AV) complete block and a permanent pacemaker was implanted. At that time echocardiography indicated an aneurysm at the left sinus of valsalva. In 2003, the patient was re-admitted to our clinic with complaints of shortness of breath and fatigue. echocardiography showed a sinus of valsalva aneurysm dissecting into interventricular septum. Operation confirmed dissection of the interventricular septum and communication between this cavity and the aneurysm of the left sinus of valsalva. The postoperative course was uneventful and the patient was discharged in a satisfactory condition. This is the first reported case of aneurysm of the sinus of valsalva dissecting into interventricular septum late and complicating aortic valve replacement.
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8/31. Aneurysm of sinus of valsalva dissecting into interventricular septum with left ventricular communication.

    Septal dissection with left ventricular communication is a rare complication of aneurysm of sinus of valsalva. This report describes a case of aneurysm of sinus of Valsalva with septal dissection, almost in its entirety with left ventricular communication--which is a very rare occurrence.
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9/31. Mycotic aneurysms of aortic root and aorta-to-left atrial fistula complicating bicuspid aortic valve endocarditis.

    Unlike root abscess, fistula formation is quite uncommon in aortic valve endocarditis. In this report, we describe a patient with subacute bicuspid aortic valve endocarditis complicated by aortic insufficiency, mycotic aneurysms of the aortic root and fistulous communication between the aorta and the left atrium and his recovery upon surgical treatment.
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10/31. Aortic branch artery pseudoaneurysms accompanying aortic dissection. Part I. Pseudoaneurysm anatomy.

    PURPOSE: Small areas of blood flow are sometimes seen within an otherwise thrombosed false lumen on computed tomography (CT) scans of intramural hematomas of the aorta. These are blood-filled spaces that, although they have no apparent communication with the true lumen, appear isodense with the aorta on contrast-enhanced CT scans. The purpose of this report is to describe angiographic and autopsy studies that establish the nature of this entity and describe the principal CT features distinguishing it from a penetrating ulcer. MATERIALS AND methods: Conventional angiographic and CT aorta findings in two cases with small collections of contrast material within an otherwise thrombosed false lumen of an aortic dissection are discussed. Also examined is another case with pathologic and histologic findings in addition to those of small collections of contrast material within an otherwise thrombosed false lumen of an aortic dissection, which illustrate the pathoanatomy of these lesions. RESULTS: Angiographic and necropsy evidence shows that some of these lesions represent branch artery pseudoaneurysms and, as such, are secondary to an intramural hematoma, not the primary cause of it. CONCLUSIONS: Difficulty in demonstrating communication between these collections of contrast material and the adjacent true lumen of the aorta on helical CT examinations and the characteristic location of these lesions along the nonpleural portion of the aortic circumference distinguish them from penetrating ulcers and should suggest the diagnosis of branch artery pseudoaneurysm. Demonstration of a branch artery originating from the contrast collection confirms the diagnosis. These branch artery pseudoaneurysms should be distinguished from penetrating atherosclerotic ulcers.
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