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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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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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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 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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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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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Sternal Pseudoaneurysm After Cardiac Surgery.

Sarah Hickman1, Ansab Fazili1, Katherine Parkin1

  • 1St Bartholomew's Hospital, Barts Health NHS Trust, Department of Radiology, London, United Kingdom.

JACC. Case Reports
|June 6, 2025
PubMed
Summary
This summary is machine-generated.

A rare presternal pseudoaneurysm developed in a patient post-cardiac surgery. Imaging revealed it originated from the internal mammary artery, caused by a sternal wire, requiring urgent repair.

Keywords:
doppler ultrasoundinternal mammary arterypseudoaneurysms

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Medical Imaging

Background:

  • Reviews a rare case of presternal pseudoaneurysm following cardiac surgery.
  • Highlights the importance of considering rare complications after procedures like aortic valve replacement and ascending aorta repair.

Observation:

  • An 80-year-old male presented with a pulsatile mass over the manubrium two months post-cardiac surgery.
  • Ultrasound and arterial computed tomography (CT) confirmed a 2x6 cm presternal pseudoaneurysm originating from a branch of the right internal mammary artery.

Findings:

  • The pseudoaneurysm was caused by friction from a residual sternal wire irritating the internal mammary artery.
  • This case underscores the diagnostic utility of ultrasound and CT angiography in identifying such rare post-surgical complications.

Implications:

  • Emphasizes the need for vigilance in diagnosing sternal pseudoaneurysms after cardiac procedures.
  • Provides insights into imaging findings and management options, including surgical and endovascular approaches, for sternal pseudoaneurysms.