Pulsating suprasternal lump: a diagnostic and management dilemma

Area of Science:

• Cardiovascular Surgery
• Vascular Anomalies
• Thoracic Surgery

Background:

• A 70-year-old female presented with significant symptoms of dyspnea and a palpable suprasternal mass.
• This case highlights a rare congenital vascular anomaly involving the great vessels of the aortic arch.
• The patient's symptoms suggested potential hemodynamic compromise due to the arterial malformation.

Observation:

• Computed Tomography (CT) imaging revealed significant dilatation of the innominate artery.
• Intraoperative findings confirmed tortuous arteries and an unusual common origin of the left common carotid artery and the innominate artery.
• The anatomical variations presented a complex surgical challenge.

Findings:

• Surgical intervention involved the division and subsequent reimplantation of the innominate artery to the ascending aorta.
• This complex reconstructive procedure successfully addressed the arterial malformation.
• Post-operative assessment confirmed complete resolution of the patient's presenting symptoms.

Implications:

• This case demonstrates the feasibility and efficacy of surgical correction for complex innominate artery anomalies.
• Successful surgical management can lead to complete symptom relief and improved quality of life.
• Further research into the long-term outcomes of such rare vascular reconstructions is warranted.