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. 2019 Apr;7(2):63-66.
doi: 10.1055/s-0039-1688439. Epub 2019 Sep 17.

A Case of Type I Debranching Complicated by Anastomotic Pseudoaneurysm: Do Not Ask Too Much of the Ascending Aorta

Davide Carino  1 , Alberto Molardi  1 , Tiziano Gherli  1 , Francesco Nicolini  1 , Andrea Agostinelli  1
Affiliations

A Case of Type I Debranching Complicated by Anastomotic Pseudoaneurysm: Do Not Ask Too Much of the Ascending Aorta

Davide Carino et al. Aorta (Stamford). 2019 Apr.

Abstract

Treatment of aortic arch aneurysm with standard open surgery is technically demanding, and associated morbidity and mortality are not insignificant. In high-risk patients, hybrid procedures with debranching and reimplantation or bypass of the aortic arch vessel followed by thoracic endovascular aortic repair (TEVAR) in the aortic arch represent a valid alternative to open surgery. However, when the ascending aorta is mildly dilated, the risk of retrograde dissection increases sharply. Here, we report a case of thoracic aortic aneurysm, with normal ascending aorta diameter, treated with Type I debranching and anterograde TEVAR complicated by anastomotic pseudoaneurysm and acute endocarditis, treated ultimately with ascending aortic repair and aortic valve replacement.

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Conflict of interest statement

The authors declare no conflict of interest related to this article.

Figures

Fig. 1
Fig. 1
Computed tomographic angiogram showing the thoracic aortic aneurysm. Note the presence of the Kommerell diverticulum with the right aberrant subclavian artery and the huge cystic lesion of the left kidney.
Fig. 2
Fig. 2
The left panel shows the intraoperative angiography with total exclusion of the aneurysm and no sign of endoleak. The right panel shows the predismissed computed tomographic angiogram with normal ascending aorta and no sign of endoleak.
Fig. 3
Fig. 3
Computed tomographic angiogram showing the presence of two lumens in the ascending aorta with the three-dimensional (3D) reconstruction.
See this image and copyright information in PMC

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