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Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm IV: Nursing Management01:22

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Aortic Regurgitation I: Introduction01:15

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Iatrogenic aortic pseudoaneurysm: a forgotten complication.

Samuel Almeida1, Pedro Bico1, António R Almeida1

  • 1Serviço de Cardiologia, Hospital de Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|February 11, 2014
PubMed
Summary

A rare ascending aortic pseudoaneurysm after cardiac surgery requires prompt diagnosis and treatment. This case highlights the challenges in managing recurrent pseudoaneurysms and associated infections, emphasizing surgical repair with aortic allografts for successful outcomes.

Keywords:
Ascending aorta pseudoaneurysmCardiac surgery complicationComplicação pós‐cirurgia cardíacaMitral valvuloplastyPseudoaneurisma da aorta ascendenteValvuloplastia mitral

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Pseudoaneurysms of the ascending aorta are infrequent but serious complications following cardiac surgery.
  • Delayed diagnosis and treatment of ascending aortic pseudoaneurysms are associated with a poor prognosis.

Observation:

  • A 66-year-old woman developed a pseudoaneurysm of the ascending aorta 12 days after mitral valvuloplasty.
  • Initial presentation included new-onset atrial fibrillation and a right atrial clot, treated with anticoagulation and antibiotics.
  • Recurrence of a large pseudoaneurysm compressing the superior vena cava occurred after initial surgical repair and conservative management of a sternal abscess.

Findings:

  • The patient underwent three surgical interventions, including repair with an aortic allograft for the recurrent, infected pseudoaneurysm.
  • Successful debridement of infected tissue and aortic allograft placement resolved the complication without postoperative issues.

Implications:

  • This case underscores the importance of vigilant monitoring for pseudoaneurysm development after cardiac procedures.
  • Complex cases of recurrent and infected aortic pseudoaneurysms may necessitate advanced surgical techniques, such as aortic allograft reconstruction.
  • Effective management requires a multidisciplinary approach involving cardiac surgeons, infectious disease specialists, and critical care teams.