1/188. aorta-cutaneous fistula as a rare complication of localized chronic mediastinitis.A 35-year-old man was admitted 5 years after congenital heart surgery complicated by staphylococcus aureus and a cutaneous fistula located at the left fourth intercostal space. He was febrile (40 degrees C), suffering from sternal pain and suppuration from the old fistula. During examination arterial blood suddenly discharged from the fistula, so that surgery was immediately instituted. An infected Dacron tube implanting on the ascending aorta for a central aorto-pulmonary shunt was at the origin of a false aneurysm: this had led to the repeat formation of an aorta-cutaneous fistula and outbreak of external bleeding.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/188. Fatal fungal infection complicating aortic dissection following coronary artery bypass grafting.The case of a 52-year-old man with severe coronary atheroma/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went on to suffer a massive fatal haemoptysis. autopsy revealed candida infection of the graft with a secondary aortobronchial fistula.- - - - - - - - - - ranking = 0.125keywords = fistula (Clic here for more details about this article) |
3/188. Urgent aortic valve replacement in disseminated gonococcaemia associated with sinus of valsalva aneurysm and fistula formation.A patient with aortic valve disruption due to gonococcal endocarditis and associated with a sinus of valsalva aneurysm and fistula into the right ventricle is described. The rarity of this combination of conditions and the place of surgery in their management are discussed.- - - - - - - - - - ranking = 0.625keywords = fistula (Clic here for more details about this article) |
4/188. Coil embolization of a false aneurysm with aorto-cutaneous fistula after prosthetic graft replacement of the ascending aorta.AIM: To report palliative embolization of a false aneurysm over the distal suture line of an ascending aorta graft replacement. MATERIAL AND METHOD: A 78-year-old male patient was admitted for increasing bleeding of a chronic manubrium ulceration, 20 months after coronary artery bypass complicated by perioperative ascending aorta dissection requiring prosthetic graft replacement. One month later, he underwent epiploplasty for a mediastinitis followed by long-term antibiotic therapy. Five months later, he presented with a manubrium ulceration of the sternotomy. Spiral computerized tomography (CT) and aortography revealed a 20 mm anterior peri-prosthetic false aneurysm with a wide neck. Advanced age, active mediastinitis and patient's objection led us to perform percutaneous occlusion according to the Moret remodeling technique while protecting the coils release with balloon catheter inflation. RESULTS: No post-operative complication was observed and at 1-year follow-up the patient was doing well with no recurrent bleeding. magnetic resonance imaging (MRI) and spiral CT controls confirmed coils stability without any internal flow. CONCLUSION: Percutaneous coils embolization of a large false aneurysm in the ascending aorta can be a palliative treatment in a surgically unsuited patient.- - - - - - - - - - ranking = 0.5keywords = fistula (Clic here for more details about this article) |
5/188. Gastrointestinal complications of aortic bypass surgery.Gastrointestinal bleeding following abdominal aortic bypass surgery is not uncommon, as approximately 20% of patients with abdominal aortic aneurysms have peptic ulcer disease. We have recently seen three patients who presented with gastrointestinal bleeding secondary to the complications of their surgery. The cause of the bleeding was aortoduodenal fistula, graft erosion into the sigmoid colon and ischaemic colitis respectively. The correct diagnosis was only considered in one patient, although in retrospect it should have been suggested in all three. Our experiences with these complications and their clinical and radiological presentation form the basis for this paper.- - - - - - - - - - ranking = 0.125keywords = fistula (Clic here for more details about this article) |
6/188. Aortocolic fistula, a lethal cause of lower gastrointestinal bleeding: report of a case.Aortocolic fistula occurs with spontaneous rupture of aortic and iliac aneurysms into the sigmoid colon, or due to involvement of the aneurysmal wall by acute diverticulitis. In the eight cases reviewed, this complication proved uniformly lethal, although sufficient clinical findings were present for diagnosis, and adequate time was available for a planned therapeutic approach. Lower gastrointestinal bleeding in the patient who has an aortic aneurysm and left-lower-quadrant inflammation suggests the presence of an aortocolic fistual. angiography should be performed during a bleeding episode to confirm the diagnosis. Surgical correction consists of an axillofemoral by pass graft, excision of the aortic aneurysm, and a Hartmann procedure.- - - - - - - - - - ranking = 0.625keywords = fistula (Clic here for more details about this article) |
7/188. Primary repair with in-situ interposition graft for infrarenal mycotic aortic pseudoaneurysm.This is a case report of a pseudoaneurysm due to salmonella aortitis in a 52 year old man. The condition is rare and represents one of the few cases reported in malaysia. The diagnosis was made preoperatively by ultrasonography and computed tomography. This was confirmed at surgery where there was a 3 cm defect at the posterior wall of the aorta at L2/3 level. The aneurysmal sac extended to the retrocrural space at the 12th vertebra level cranially on the right side to the lower border of the 3rd lumbar vertebra caudally. It had a smooth fibrous wall and contained a mixture of organised haematoma and pus. At operation the aneurysm was excised, the affected region was carefully debrided and the aorta grafted with an in-situ in-lay graft. Antibiotic therapy was instituted until clinical response was evident, leukocytosis was reduced and blood culture was negative. However 4 months after surgery, the patient returned in irreversible shock and succumbed to disseminated intravascular coagulation secondary to massive upper gastrointestinal haemorrhage from an aortoduodenal fistula.- - - - - - - - - - ranking = 0.125keywords = fistula (Clic here for more details about this article) |
8/188. Aortic dissection with fistula to right atrium after heart transplantation: diagnosis by transthoracic and transesophageal echocardiography.Aortic dissection with rupture into the right atrium is an extremely rare and rapidly fatal condition that may occur after cardiac surgery. We report the case of a 59-year-old woman with a 6-year history of heart transplantation who presented with subacute illness characterized by chest pain and severe cardiac decompensation accompanied by a continuous murmur in the precordium. The diagnosis of aortic dissection complicated by right atrial fistula was made by the combination of transthoracic and transesophageal echocardiographic examination.- - - - - - - - - - ranking = 0.625keywords = fistula (Clic here for more details about this article) |
9/188. Aortic dissection complicated with aorto-right atrium fistula.Aorto-right atrium fistula associated with aortic dissection is a very rare complication. Here report a case of successful surgical repair of ascending aortic dissection complicated with aorto-right atrium fistula. A 65-year-old man was presented with sudden chest pain and dyspnea. Fifteen years ago, he had aortic valve replacement. An aortic dissection with fistula to the right atrium was diagnosed by echocardiography and cardiac catheterization. At operation, dense adhesion of the aortic root due to the previous cardiac operation was confirmed, and this was suggested as the cause for this rare complication.- - - - - - - - - - ranking = 0.875keywords = fistula (Clic here for more details about this article) |
10/188. Aortobiventricular fistulas associated with pseudoaneurysm of the ascending aorta 12 years after patch repair of supravalvular aortic stenosis.Fistula formation between the aorta and cardiac chamber is a rare complication of the ascending aortic aneurysm. A 27 year-old man undergoing successful patch aortoplasty for supravalvular aortic stenosis 12 years before admission had a high fever, infectious signs in blood laboratory data, and congestive heart failure. Transthoracic and transesophageal echocardiography revealed a pseudoaneurysm of the aortic root and aortobiventricular fistulas. Detachment of the proximal end of the aortic patch was thought to be the cause of the pseudoaneurysm. debridement of necrotic tissue surrounding fistulas produced large defects in the anterior wall of the right ventricle, interventricular septum, and ascending aorta. A modified Konno operation effectively reconstructed the outflow tracts of both ventricles and the aorta.- - - - - - - - - - ranking = 0.75keywords = fistula (Clic here for more details about this article) |
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