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Published on: September 9, 2020
Intermittent circulatory arrest for repairing postoperative mycotic pseudoaneurysm in the ascending aorta
Takahiko Misumi1, Mikihiko Kudo, Shinichi Taguchi
1Division of Cardiovascular Surgery, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
Abstract:
Postoperative mycotic pseudoaneurysm in the ascending aorta associated with mediastinitis is one of the most serious complications after cardiovascular surgery. Circulatory arrest is usually needed for repairing this lesion; it is likely that the procedure needs unpredictably prolonged arrest time due to uncontrollable bleeding or serious adhesion. With this reason we employed intermittent circulatory arrest instead. The purpose of this paper is to describe 2 cases which demonstrated the method of intermittent circulatory arrest for repairing postoperative mycotic pseudoaneurysm in the ascending aorta.
Insights
This study presents intermittent circulatory arrest as a safer technique for repairing serious aortic pseudoaneurysms after heart surgery. This method helps manage bleeding and adhesions during complex aortic repair procedures.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Infectious Disease
Background:
- Postoperative mycotic pseudoaneurysm of the ascending aorta is a severe complication following cardiovascular surgery.
- Mediastinitis can further complicate these aortic pseudoaneurysms, increasing surgical risk.
- Standard repair often necessitates prolonged circulatory arrest, posing significant risks.
Observation:
- Two cases of postoperative mycotic pseudoaneurysm in the ascending aorta were managed.
- The surgical approach utilized intermittent circulatory arrest instead of continuous arrest.
- This method was employed due to concerns of uncontrollable bleeding and adhesions.
Findings:
- Intermittent circulatory arrest was successfully utilized in two patients with complex aortic pseudoaneurysms.
- This technique allowed for controlled management during the repair of mycotic pseudoaneurysms associated with mediastinitis.
- The approach potentially mitigates the risks associated with prolonged circulatory arrest.
Implications:
- Intermittent circulatory arrest may offer a viable alternative for managing complex postoperative aortic pseudoaneurysms.
- This technique could improve outcomes in high-risk cardiovascular surgery patients.
- Further research is warranted to validate the safety and efficacy of intermittent circulatory arrest in aortic surgery.
