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Tuberculous ascending aortic pseudoaneurysm

Syed Shahabuddin1, Shahid Ahmed Sami

  • 1Cardiothoracic Surgery, The Aga Khan University Hospital, Karachi, Pakistan.

Interactive Cardiovascular and Thoracic Surgery
|June 25, 2013
PubMed

Insights

Tuberculous pseudoaneurysms of the ascending aorta are rare. This case highlights successful surgical repair and antituberculous chemotherapy for a young patient, improving outcomes for this challenging condition.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Infective pseudoaneurysms of the ascending aorta present a significant clinical challenge, associated with high morbidity and mortality.
  • While previous cardiac surgery is a common risk factor, these aneurysms can also occur in patients without prior surgical history.
  • Various microorganisms can cause these pseudoaneurysms, with tuberculous etiology being exceptionally rare.

Observation:

  • A 25-year-old male presented with dyspnea and recurrent hemoptysis, indicative of a serious underlying cardiovascular and pulmonary issue.
  • Preoperative assessments, including clinical evaluation, radiological imaging, and echocardiography, were crucial in diagnosing the ascending aortic pseudoaneurysm.

Findings:

  • The patient underwent successful surgical repair of the ascending aortic pseudoaneurysm via excision and Dacron tube graft replacement under cardiopulmonary bypass.
  • Histological examination confirmed the tuberculous nature of the pseudoaneurysm, guiding postoperative treatment.

Implications:

  • This case underscores the importance of considering rare infectious etiologies, such as tuberculosis, in the differential diagnosis of ascending aortic pseudoaneurysms.
  • Successful surgical management combined with targeted antituberculous chemotherapy offers a viable treatment strategy for this life-threatening condition.
  • Early diagnosis and prompt intervention are critical for improving patient outcomes in cases of infective ascending aortic pseudoaneurysms.
Keywords:
Cardiopulmonary bypassMycotic aneurysmTubeculous infection

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