Pseudoaneurysm of ascending aorta: a rare complication of mediastinitis following coronary artery bypass surgery (original) (raw)

2010, Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology

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The paper presents a case of pseudoaneurysm of the ascending aorta following a challenging internal jugular vein cannulation procedure in a morbidly obese patient. Subsequent investigations revealed a periaortic hematoma and a dissection of the ascending aorta, necessitating transfer to a surgical unit for urgent repair. The case highlights the rare but severe complications associated with central venous access, particularly in patients with anatomical challenges and atherosclerosis, and emphasizes the need for proper training and potential sonographic guidance to minimize risks.

Pseudoaneurisma iatrogénico da aorta ascendente: uma complicação esquecida

Revista Portuguesa de Cardiologia, 2014

Pseudoaneurysms of the ascending aorta are a rare complication of cardiac surgery. However, the poor prognosis associated with this condition if untreated makes early diagnosis and treatment important. We present the case of a 66-year-old woman who had undergone mitral valvuloplasty 12 days previously, who was admitted with a diagnosis of new-onset atrial fibrillation. The transthoracic echocardiogram showed a thrombus in the right atrium and anticoagulation was initiated, followed by antibiotic therapy. After further investigation, the patient was diagnosed with a pseudoaneurysm of the ascending aorta and underwent surgical repair, followed by six weeks of antibiotic therapy. She was readmitted six months later for an abscess of the lower sternum and mediastinum. After a conservative approach with antibiotics and local drainage failed, recurrence of a large pseudoaneurysm compressing the superior vena cava was documented. A third operation was performed to debride the infected tissue and to place an aortic allograft. There were no postoperative complications.

Caso 04/12: homem, 44 anos, portador de valvopatia reumática com múltiplas cirurgias de trocas valvares aórticas, internado para tratamento de insuficiência cardíaca congestiva

Arquivos Brasileiros de Cardiologia, 2012

Male, 44 years old, with a history of rheumatic attacks in childhood and adolescence and multiple aortic valve replacement surgeries, was admitted with decompensated heart failure. The present illness began with rheumatic attacks characterized by fever, arthritis of the right knee, when he was 7-11 old. At age 15, paroxysmal palpitations appeared. At age 16, the patient initiated follow-up at the outpatient services at InCor. Double aortic lesion and rheumatic disease activity were diagnosed. At the time, the electrocardiogram (ECG) revealed severe left ventricular hypertrophy; a chest radiograph revealed cardiomegaly +++/ 4+. At age 17, the palpitations became more frequent, dyspnea on moderate exertion appeared. Physical examination in primary care (May 1977) revealed pulse rate of 80 bpm, blood pressure 100/0 mmHg; auscultation was normal, cardiac auscultation revealed systolic murmur +++/ 4+ in the aortic area and diastolic murmur in the left sternal border. There was also the presence of a third heart sound; the abdomen showed no changes, no edema, and the pulse was of rapid ascent and descent. The patient was under use of digoxin (0.25 mg daily) and prophylaxis of rheumatic fever with benzathine penicillin 1.2 million units intramuscularly (IM) every two weeks. Surgical treatment of the aortic valve was prescribed.

Cirurgia para salvamento de vida após ruptura de pseudoaneurisma da artéria ilíaca: relato de caso

Jornal Vascular Brasileiro, 2010

Vascular injury secondary to hip surgery is uncommon in that the reported incidence of major vascular injury after surgical procedures on the hip is only 0.25% 1. The development of a pseudo aneurysm after total hip arthroplasty (THA) is an extremely rare complication. Most reported cases are acute in onset and are usually due to direct trauma during the operative procedure 1. We reported an unusual case of ruptured pseudo aneurysm and control of life-threatening intra-operative hemorrhage of the external iliac artery in a patient with displaced THA, planned for removal, occurring two years after the last hip surgery. Case report A 68-year-old Saudi male patient was admitted for removal of infected total right hip replacement (THR), which was revised in 2000. A chronic hip sinus has developed following the revision surgery with continuous oozing, which, on occasions, was bloody. However, the culture swabs from the exudates were negative. Gradually, symptoms of pain and decreased hip motion have developed. He noticed right leg swelling prior to his admission to our hospital. He had other systemic medical diseases (diabetes mellitus and hypertension). During examination, he had normal temperature and non-pitting edema in the right leg. Distal pulses were present

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