Cases reported "Aortic Aneurysm"

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11/172. Surgical treatment of annuloaortic ectasia with coronary aneurysm and fistula.

    Annuloaortic ectasia associated with a giant aneurysm of the left coronary artery and a coronary artery fistula is extremely rare, and it is difficult to decide how to repair this complex lesion. The cause of the huge aneurysm of the left coronary artery in our patient was thought to be cystic medial necrosis, the coronary artery fistula, or both. The surgical management of this extremely rare pathological combination is described.
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12/172. Ruptured sinus of valsalva aneurysm with aortic-left atrial fistula.

    We report the case of a previously healthy 56-year-old male who suddenly developed severe chest pain and pulmonary edema. cardiac catheterization and angiography revealed an aneurysm of the noncoronary sinus of valsalva which had ruptured into the left atrium. This was confirmed at operation and it was noted that there were no signs of bacterial infection or rheumatic valve disease. We therefore concluded that the aneurysm was of congential origin. A successful repair of the defect was carried out and the patient made a satisfactory recovery. There are only 3 other reported cases of rupture of a congenital sinus of Valsalva aneurysm into the left atrium, and in only one case did the aneurysm originate from the noncoronary sinus and this patient had associated rheumatic aortic and mitral valve disease. We have received the classification of sinus of Valsalva aneurysms, the associated congenital and acquired defects and the presenting features of unruptured and ruptured aneurysms.
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13/172. Pseudoaneurysm and ilio-caval fistula caused by malignant fibrous histiocytoma of the aorta--CT diagnosis and angiographic confirmation.

    We report a case of a malignant fibrous histiocytoma (MFH) of the aortic bifurcation, which manifested as a pseudoaneurysm with the formation of an ilio-caval fistula, a complication about which, to our knowledge, nothing has been published previously. Spiral CT, catheter arteriography and venography were complementary in the diagnostic procedure.
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14/172. The large spontaneous aorta inferior vena caval fistula.

    The subject of spontaneous aortocaval fistula due to a ruptured abdominal aortic aneurysm into the inferior vena cava is reviewed and discussed. An interesting case is presented with particular emphasis on the pre-operative findings which include lower body cyanosis; pain, numbness, and paralysis of the lower extremities; a cyanotic partial penile erection; and moderate shock. The cause of this syndrome is postulated.
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15/172. Aortic dissection with aorto-left atrial fistula formation soon after aortic valve replacement: A lethal complication diagnosed by transthoracic and transesophageal echocardiography.

    Fistulas between the aorta and left atrium are a rare manifestation of aortic dissection and are infrequently diagnosed premortem. We report the case of a 70-year-old man who exhibited this condition soon after aortic valve replacement and eventually died from rapidly developing refractory congestive heart failure. The diagnosis was indicated by transthoracic echocardiography and was ultimately made with transesophageal echocardiography and color flow Doppler imaging. Transesophageal echocardiography is the procedure of choice for establishing the correct diagnosis and leading to prompt surgical repair of this lethal condition.
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16/172. Successful management of spinal dural arteriovenous fistulas undetected by arteriography. Report of three cases.

    Spinal dural arteriovenous fistulas (AVFs) frequently cause progressive myelopathy. When they are localized by imaging studies, surgery can be safely performed by simply interrupting the vein draining the fistula intradurally, and the results will be excellent and lasting. In some patients with clinical features of a spinal dural AVF and in whom magnetic resonance imaging and/or myelography findings are consistent with a diagnosis of a spinal dural AVF, however, spinal arteriography demonstrates no such results. The authors used a simple strategy based on knowledge of the epidemiology, pathophysiology, and anatomy of spinal dural AVFs to manage these cases successfully. In two patients, atherosclerotic occlusion was the primary cause for the failure of arteriography to visualize the dural AVF. The presence of an aortic aneurysm was an additional contributing factor preventing arteriographic visualization in one of these patients. In a third patient, massive obesity, and aortic atheroslerosis and tortuosity contributed to the absence of findings on three spinal arteriograms before surgical exploration lead to a more focused arteriographic examination that was successful.
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17/172. Coronary artery aneurysm with a fistulous connection to the right atrium mimicking a sinus of valsalva aneurysm.

    Coronary artery aneurysms are uncommon and may be complicated by rupture, thromboembolic phenomenon, and more rarely fistulation into one of the cardiac chambers. This case report highlights the difficulty in making a preoperative diagnosis of a coronary artery aneurysm that has fistulated into the right atrium, and lists possible differential diagnoses.
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18/172. Stanford type A aortic dissection which ruptured into the left atrium: report of a case.

    A Stanford type A aortic dissection ruptures usually into the pericardial space or the mediastinal space. We herein report the rare surgical case of a Stanford type A aortic dissection which ruptured into the left atrium. The patient had a previous history of mitral valve replacement. The time and the cause of the aortic dissection was unclear. At operation, adhesions around the proximal aorta and between the aortic root and the left atrial roof were confirmed to be one of the causes for this rare form. A fistula to the cardiac cavity following an aortic dissection may occur in any patient, especially in those with a history of previous cardiac surgery.
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19/172. Treatment of a fistula at the distal anastomosis after Bentall operation with endoluminal covered stent.

    A 25-year-old Marfan patient was operated on for an acute type A aortic dissection that was complicated twice by false aneurysms at the distal suture line. At the third episode a covered endoprosthesis was inserted in the ascending aorta between the coronary ostia and the inominate artery. The postoperative course was uneventful and a control computed tomographic scan showed complete occlusion of the false aneurysm. This attractive technique should be considered versus an open-heart operation in selected patients.
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20/172. Paraprosthetic-enteric fistula. role of Preoperative endoscopy.

    A case of paraprosthetic-enteric fistula occurring after aortic aneurysectomy and Dacron graft placement is reported. Two and one-half years after aneurysectomy, the patient presented with the problems of fever of obscure origin, arthralgias, and anemia. The diagnosis of paraprosthetic-enteric fistula was made preoperatively by endoscopy. The role of endoscopy in the evaluation of postaneurysectomy complications is emphasized.
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