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Life-threatening aortic hemorrhage during pectus bar removal
Marek Jemielity1, Krystian Pawlak, Cezary Piwkowski
1Department of Cardiac Surgery, Poznań University of Medical Sciences, Poznań, Poland.
The Annals of Thoracic Surgery
|January 25, 2011
Summary
A rotated sternum bar from a Nuss operation caused late aortic hemorrhage and an aortomediastinal fistula 3 years post-surgery. Treatment involved cardiopulmonary bypass and aortic prosthesis implantation.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Device Complications
Background:
- The Nuss procedure is a minimally invasive technique for correcting pectus excavatum.
- Late complications after the Nuss procedure are rare but can be severe.
- Sternum bar migration or rotation can lead to unforeseen consequences.
Observation:
- A patient presented with late aortic hemorrhage three years after a Nuss operation.
- The hemorrhage was linked to a rotated sternum stabilizing bar.
- Chronic aortic damage and an aortomediastinal fistula were identified as the cause.
Findings:
- A rotated sternum bar caused chronic injury to the aorta.
- This chronic injury resulted in the formation of an aortomediastinal fistula.
- The complication necessitated complex surgical intervention.
Implications:
- Highlights the importance of long-term monitoring after Nuss procedures.
- Underscores the potential for delayed complications from implanted thoracic devices.
- Emphasizes the need for prompt diagnosis and management of aortomediastinal fistulas.
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