A case of acute heart failure due to giant aortic pseudoaneurysm with fistulization to the right ventricle after a modified Bentall operation

Abstract

Simultaneous en bloc replacement of the ascending aorta and aortic valve by a composite valve graft, as first described by Bentall and De Bono in 1968 and with later modifications, has become the standard surgical technique in the treatment of aneurysms of the aortic root associated with severe aortic valve dysfunction. Despite the good surgical results overall, it is still associated with considerable perioperative mortality and with dire complications in the long run. We report a case of a giant aortic pseudoaneurysm compressing the right heart chambers and communicating with the right ventricle presenting as rapidly progressing heart failure a few months after a Bentall operation.

A rare case report of an acquired aortopulmonary artery fistula after Bentall procedure: multimodality imaging approach may be the key?

“…In this setting, pseudoaneurysms originating from dehiscence of suture lines are one of the most feared and lethal complication, with a highly variable and anecdotic incidence. 8 , 9 They evolve insidiously and can cause life-threatening conditions such as compression and fistulation to other structures. 8 , 9 In our case, the pseudoaneurysm had already caused the fistulation to the pulmonary artery, resulting in an APF and pulmonary hyper flow.…”

“… 8 , 9 They evolve insidiously and can cause life-threatening conditions such as compression and fistulation to other structures. 8 , 9 In our case, the pseudoaneurysm had already caused the fistulation to the pulmonary artery, resulting in an APF and pulmonary hyper flow.…”

Huge Aortic Pseudoaneurysm Arising from the Aorta-Saphenous Vein Graft Anastomosis after Coronary Artery Bypass Grafting

“…PsA of the ascending aorta is a potentially fatal complication after thoracic surgical procedures, usually related to aortic cannulation, the needle vent site, the proximal site of venous or arterial graft anastomosis, the suture line of aortotomy, or the aortic clamp site [Tochii 2011]. Infection, connective tissue disorders, preoperative hypertension, aortic cannulation, blowout of the aortotomy, vasculitis, and prior aortic or cardiac surgery are important risk factors for PsA [Almeida 2008]. But etiology of the aneurismal formation still was not clear.…”

Giant pseudoaneurysm of the aortic arch and successful surgical repair

“…2 Pseudoaneurysms of the aorta have multiple etiologies including trauma, infection, connective tissue diseases, vasculitis, and prior aortic or cardiac surgery. 3,4 The time course for development of aortic pseudoaneurysm is reported to vary from a few months to several decades. The spectrum of presenting symptoms includes chest pain, pressure, cough, dyspnea, syncope, hoarseness of voice, and even frank hemoptysis.…”