Video-assisted thoracic surgery for cancer after thoracic aortic aneurysm repair

Taylor, Lauren J.; Adesoye, Taiwo; Maloney, James D.

doi:10.1177/0218492315610264

Cited by 1 publication

(2 citation statements)

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“…Pleural adhesions due to the aortic inflammatory response are not uncommon after TEVAR, and a cautious aortic exposure limiting as much as possible pleural and lung lesions is advocated to reduce postoperative respiratory complications [9]. VATS for thoracic aortic aneurysm is also beneficial because it is less invasive than open surgery [7]. In cases after EVAR for abdominal aortic aneurysm, successful laparoscopic fenestration of the aneurysm sac with removal of all thrombotic material has been reported [5] [6] [8]; however, there have been few reports describing the usefulness of VATS as late open conversion after TEVAR.…”

Section: Discussionmentioning

confidence: 99%

“…Open surgery necessitates thoracotomy and can cause lung injury during dissection of pleural adhesions. Video-assisted thoracic surgery (VATS) is reportedly less invasive for open surgical repair and effective for the dissection of adhesions between the aorta and the lung [7]. Herein, we report a case of successfully open repair using VATS for residual aneurysm after aortic arch repair.…”

Section: Introductionmentioning

confidence: 99%

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Video-Assisted Thoracic Surgery for Residual Aneurysm after Total Arch Replacement

Sugiyama¹,

Watanuki²,

Futamura³

et al. 2021

OJTS

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Background: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their management is controversial. One treatment option is late open surgical conversion; however, postoperative respiratory complications resulting from the dissection of pleural adhesions, which is frequently necessary with this approach, are often unavoidable. Case presentation: Herein, we report a case of open surgical repair of a residual distal aortic arch aneurysm that occurred after total arch replacement and thoracic endovascular aortic repair. Contrast-enhanced magnetic resonance imaging was not possible in this case due to the patient's severe renal dysfunction; however, contrast-enhanced computed tomography using minimal contrast did not detect remarkable leakage through the graft or stent graft into the aneurysm. Late open surgical conversion using video-assisted thoracic surgery was performed by thoracic surgeons, and the adhesion between the aortic wall and the lung was safely and effectively dissected. Because there was no significant pulsation or evidence of feeding arteries in the aortic wall, the aortic wall was opened carefully. No bleeding or backflow from any branch arteries into the aneurysm was noted, so the aortic wall was ligated with continuous sutures. The patient recovered without experiencing any major complications. Conclusions: This case report demonstrates that video-assisted thoracic surgery is safe and effective for late open conversion in cases of residual aneurysm; furthermore, this case suggests that video-assisted thoracic surgery may be particularly beneficial for the dissection of adhesions between the aortic wall and lung in these cases.

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