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Second Redo for Composite Graft Pseudoaneurysm with Transcutaneous Rupture
Mikael Péterffy1, Christian Olsson1
1Department of Molecular Medicine and Surgery, Cardiovascular Surgery Unit, The Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
Aorta (Stamford, Conn.)
|January 23, 2016
Summary
A patient developed a new pseudoaneurysm after prior surgery. Prompt re-repair using hypothermic circulatory arrest led to an uneventful recovery, demonstrating successful management of coronary artery pseudoaneurysms.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Medical Imaging
Background:
- Previous composite graft surgery for pseudoaneurysms.
- Recurrence of pseudoaneurysms at new sites, including the left coronary artery.
Purpose of the Study:
- To report a case of recurrent coronary artery pseudoaneurysm after composite graft repair.
- To describe the successful acute re-repair of a ruptured left coronary artery pseudoaneurysm.
Main Methods:
- Computed tomography (CT) and angiography for diagnosis.
- Emergency re-operation with presternotomy and hypothermic circulatory arrest.
Main Results:
- Successful diagnosis of a new left coronary artery pseudoaneurysm.
- Acute re-repair achieved with hypothermic circulatory arrest.
- Resolution of temporary postoperative neurological dysfunction and uneventful recovery.
Conclusions:
- Composite graft repair can be complicated by recurrent pseudoaneurysms.
- Prompt diagnosis and surgical intervention, including hypothermic circulatory arrest, are crucial for managing ruptured coronary artery pseudoaneurysms.
- This case highlights the successful management of complex vascular complications post-cardiac surgery.
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