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Endovascular repair of ascending aortic pseudoaneurysm in a high-risk patient

Guido Gelpi1, Giovanni Cagnoni, Paolo Vanelli

  • 1Cardiovascular Surgery Division of L. Sacco Hospital, University of Milan, Milan, Italy. gelpi.guido@hsacco.it

Interactive Cardiovascular and Thoracic Surgery
|December 27, 2011
PubMed

Insights

Endovascular repair using aortic cuffs successfully treated a large, acute mycotic ascending aortic pseudoaneurysm in a high-risk patient. This minimally invasive approach offers a promising alternative for complex aortic pathologies.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Vascular Endovascular Therapy

Background:

  • Mycotic ascending aortic pseudoaneurysm (AAP) presents significant surgical challenges with high mortality.
  • Complex aortic pathologies often require innovative treatment strategies, especially in high-risk individuals.

Observation:

  • A 45-year-old male with HIV, HBV, and HCV, post-sternotomy, presented with an 11.6 cm rapidly growing mycotic AAP.
  • The patient had a history of multiple sternotomies, increasing surgical risk.

Findings:

  • Endovascular repair was performed using two Gore Exluder aortic cuffs inserted via the left axillary artery.
  • Nine-month follow-up CT demonstrated complete sealing of the AAP with no endoleak and significant aneurysm shrinkage.

Implications:

  • Endovascular aortic repair offers a viable, less invasive option for managing complex mycotic ascending aortic pseudoaneurysms.
  • This technique may reduce morbidity and mortality associated with traditional open surgical repair in high-risk patients.
  • Successful outcomes suggest potential for broader application in challenging cardiovascular cases.

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