Pseudoaneurysm of subclavian artery 21-years after staged repair of tetralogy of Fallot

Demyanchuk, Vitaly

doi:10.1016/s1010-7940(01)01039-9

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…In one reported case, Demyanchuk et al detected a pseudoaneurysm a long period of time after the shunt operation, and they suggested that the main cause was that the relatively short shunt did not grow simultaneously with the somatic growth of the patient. 3 In our case 1, lung computerized tomography showed that the left subclavian artery was associated with the pseudoaneurysm. In case 2, based on our experiences, we first performed cardiac catheterization.…”

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

“…The primary complications of shunt-related pseudoaneurysm include rupture and massive pulmonary hemorrhage. [1][2][3][4] We describe two children herein who had recurrent pulmonary hemorrhage secondary to pseudoaneurysms of the left subclavian artery following modified Blalock-Taussig shunt procedures.…”

Section: Introductionmentioning

confidence: 99%

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Interventions Involving the Use of Covered Coronary Artery Stents for Pseudoaneurysms of Blalock-Taussig Shunts

Başpınar

Şahin

Sülü

et al. 2016

World J Pediatr Congenit Heart Surg

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One of the most rare and dangerous complications of a modified Blalock-Taussig shunt involves the formation of a pseudoaneurysm. A pseudoaneurysm may rupture or may result in other adverse events including compression of mediastinal structures or collapse of the underlying lung parenchyma. Shunt-related pseudoaneurysm may be associated with shunt occlusion, bacteremia, or pulmonary hemorrhage. We describe two cases complicated by large pseudoaneurysm formation, following systemic-to-pulmonary artery shunt operations. The patients in question had recurrent pulmonary hemorrhage. Both underwent successful placement of covered coronary artery stents.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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Interventions Involving the Use of Covered Coronary Artery Stents for Pseudoaneurysms of Blalock-Taussig Shunts

Başpınar

Şahin

Sülü

et al. 2016

World J Pediatr Congenit Heart Surg

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“…Pseudoaneurysm formation is one of the rare but potentially fatal complications of SPSs and may be associated with shunt occlusion, infection, arterial or graft-related structural weakness, and dehiscence. The adverse events related to pseudoaneurysm may generated from rupture or compression and collapsing effect on the mediastinal structures and underlying lung parenchyma (81)(82)(83)(84)(85). Surgery is the traditional treatment, yet it may be associated with high morbidity and mortality, particularly in critically ill patients or those with active bleeding.…”

Section: Stent Implantation For Pseudoaneurysm Of Shuntmentioning

confidence: 99%

Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence

Jenab

Rezaee

Hosseini

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPatients with cyanotic complex congenital heart defects (CHDs) commonly undergo palliation with interposition of systemic-to-pulmonary shunts (SPSs). These palliative shunts are rarely found in adults with CHDs and can be complicated with progressive obstruction or total occlusion during follow-up. The best treatment option for shunt re-permeabilization is challenging and case-oriented because most patients are high risk candidates for redo surgeries. We aimed to review the current evidence on percutaneous stent implantation to treat failed SPSs.MethodsWe performed a comprehensive literature review on percutaneous stent implantation to treat failed and occluded SPSs. We also reported the case of a 33-year-old man with cyanotic CHD and a occluded central aorto-pulmonary shunt, who was successfully treated with percutaneous balloon dilatation and subsequently stent implantation at our institution.ResultWe identified and included 31 articles reporting on 150 patients and 165 stent implantations in failed SPSs. The age of patients at the time of stent implantation ranged from 6 days to 47 years. The time between the surgical shunt creation and transcatheter intervention ranged from 1 day to 17 years. Overall, 161/165 (97.5%) stent implantations were successful. The most common clinical presentation was cyanosis and decreased atrial oxygen saturations and the indication for stent implantation was shunt obstruction and stenosis.ConclusionThis review highlights the benefits of endovascular stenting to permeabilize failed SPSs in children and adults with complex CHD who are classified as poor candidates for re-surgical repair.

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“…2 These catheterization-injury-related pseudoaneurysms are usually located at or distal to the subclavianevertebral junctions, 2 and endovascular strategy is the treatment of choice in modern practice. 5 They can also occur as a consequence of shoulder dislocation, 14 local balloon dilatation, 15 BlalockeTaussing shunting, 16 or type IV EhlerseDanlos syndrome. 17 It may also follow infection of previously placed stents.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of a nontraumatic left subclavian artery pseudoaneurysm

Chen¹,

Su²,

Liu³

et al. 2012

Journal of the Chinese Medical Association

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Mycotic subclavian artery pseudoaneurysms are rare. There are controversies over the surgical or endovascular approach as the treatment of choice for these lesions. The standard surgical debridement might not be a choice for poorly surgically reachable lesions or for patients with multiple comorbidities. Endovascular aneurysm repair may be an effective alternative in selected cases. This treatment was rarely reported previously. Herein, we present a high-surgical-risk case with a highly suspected left subclavian arterial mycotic pseudoaneurysm, which, although difficult to approach surgically, was successfully managed with stent grafting and a complete antibiotic treatment course. An 89-year-old male was admitted due to intermittent fever and hemoptysis for 2 months. Salmonella group B was cultured from his sputum, and a 3.5 cm pseudoaneurysm was identified by chest multidetector-row computed tomography (MDCT) angiogram. Endovascular treatment with a graft stent was chosen due to high surgical risk and difficult surgical access to the lesion. The intervention was well planned ad hoc, based on MDCT images and meticulously performed by dual endovascular approaches. Antibiotics were continued after the procedure, and the patient was discharged from the hospital. As MDCT disclosed near-complete regression of the pseudoaneurysms 2 months later and the patient was in healthy status, antibiotics were continued for 6 months. He was readmitted 11 months later due to lacunar infarction with minor pneumonia over the left lower lung in which Salmonella enteritis was also diagnosed. After this acute event, he was again hospitalized 14 days later due to sepsis with adult respiratory distress syndrome and shortly expired despite all emergent treatment measures. No evidence of local subclavian infection recurrence was noted throughout or related to subsequent events. In conclusion, endovascular treatment of an infected subclavian artery pseudoaneurysm could be a choice in selected patients, but treatment of underlying infection determines the clinical outcome.

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Pseudoaneurysm of subclavian artery 21-years after staged repair of tetralogy of Fallot

Cited by 5 publications

References 6 publications

Interventions Involving the Use of Covered Coronary Artery Stents for Pseudoaneurysms of Blalock-Taussig Shunts

Interventions Involving the Use of Covered Coronary Artery Stents for Pseudoaneurysms of Blalock-Taussig Shunts

Percutaneous stent implantation for occluded central shunts in adults: A case report and review of current evidence

Endovascular treatment of a nontraumatic left subclavian artery pseudoaneurysm

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