Hepatic artery aneurysm repair: a case report

Area of Science:

• Vascular Surgery
• Cardiology
• Hepatology

Background:

• Hepatic artery aneurysms (HAAs) are clinically significant, with increasing incidence and high mortality from rupture.
• Surgical repair is recommended for HAAs >2 cm, but comorbidities like ischemic heart disease are common.
• Managing urgent surgery in patients with recent acute coronary syndrome presents a controversial challenge.

Purpose of the Study:

• To discuss the management of hepatic artery aneurysms in patients with recent myocardial infarction.
• To evaluate the role of delayed surgery and postoperative follow-up in such cases.

Main Methods:

• A case presentation of a 58-year-old man with a 5.5 cm asymptomatic HAA.
• Delayed surgical repair and reconstruction of the hepatic artery after 3 months post-myocardial infarction.
• Postoperative monitoring using abdominal arterial duplex, liver function tests, and alpha-glutathione-S-transferase levels.

Main Results:

• Successful surgical repair and reconstruction of the common hepatic artery aneurysm.
• Confirmed graft patency and normal liver function postoperatively.
• No significant difference in cardiac risk for vascular surgery within 6-12 months of myocardial infarction.

Conclusions:

• Delayed surgical intervention for hepatic artery aneurysms is a viable option in patients with recent myocardial infarction.
• Alpha-glutathione-S-transferase is a useful marker for assessing perioperative hepatocellular damage.
• Routine outpatient follow-up ensures good patient recovery and graft patency.