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Punch-hole aneurysm of the ascending aorta after coronary artery bypass surgery

Jens Wippermann1, Johannes M Albes, Harald Brandes

  • 1Department of Cardiothoracic and Vascular Surgery, University Hospital Jena, 07743 Jena, Germany. jens.wippermann@med.uni-jena.de

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

A giant ascending aortic aneurysm after coronary artery bypass grafting (CABG) was successfully repaired. Deep hypothermic circulatory arrest (DHCA) is recommended to minimize bleeding during resternotomy for aortic repair.

Area of Science:

  • Cardiovascular Surgery
  • Aortic Aneurysm Research
  • Surgical Case Reports

Background:

  • Post-coronary artery bypass grafting (CABG) complications can include aortic issues.
  • False aneurysms of the ascending aorta pose significant surgical challenges.
  • Localized aortic rupture can lead to delayed aneurysm formation.

Purpose of the Study:

  • To report a rare case of a giant punch-hole aneurysm of the ascending aorta post-CABG.
  • To describe the surgical management of this complex aortic pathology.
  • To recommend an optimal surgical technique for such cases.

Main Methods:

  • Surgical repair of a giant ascending aortic false aneurysm.
  • Cardiopulmonary bypass and resternotomy under deep hypothermia and circulatory arrest (DHCA).
  • Closure of the ascending aorta lesion using a Dacron patch.

Main Results:

  • Successful surgical repair of the giant ascending aortic aneurysm.
  • Uneventful postoperative recovery for the patient.
  • Demonstration of the feasibility of DHCA for managing adherent aortic lesions.

Conclusions:

  • Deep hypothermic circulatory arrest (DHCA) is a safe and effective method for repairing false aneurysms of the ascending aorta, especially when adherent to the sternum.
  • DHCA minimizes blood loss during resternotomy, improving surgical outcomes.
  • Prompt surgical intervention is crucial for managing large post-CABG aortic aneurysms.

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