Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;9(5):193-195.
doi: 10.1055/s-0041-1732399. Epub 2021 Dec 8.

Giant Distal Anastomotic Pseudoaneurysm 35 Years after Bentall Operation Mimicking an "Elephant Trunk"

Raffaele Scaffa  1 , Mario Torre  1 , Antonio Longobardi  1 , David Ferrara  1 , Maria G Vassallo  1 , Francesco Itri  1 , Enrico Coscioni  1
Affiliations

Giant Distal Anastomotic Pseudoaneurysm 35 Years after Bentall Operation Mimicking an "Elephant Trunk"

Raffaele Scaffa et al. Aorta (Stamford). 2021 Oct.

Abstract

We present the case of a giant distal aortic pseudoaneurysm 35 years after a classic mechanical Bentall operation. Computed tomography and coronary angiography showed that this originated from the distal suture line. The proximal suture and coronary ostia appeared to be intact. At reoperation, we found a complete dehiscence of distal suture line: the graft was floating in the pseudoaneurysm, mimicking an "elephant trunk" procedure. This complication suggested a systematic and accurate follow-up of patients who underwent an original Bentall procedure.

PubMed Disclaimer

Conflict of interest statement

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

Figures

Fig. 1
Fig. 1
Aortography with the pig-tale catheter positioned directly inside the huge pseudoaneurysmatic sac, showing the origin from the distal Dacron graft anastomosis.
Fig. 2
Fig. 2
Computed tomography angiography scans revealed that both the coronary arteries ( A, B ) originated from the graft. The contour of the Dacron graft (white arrows) surrounded by pseudoaneurysm ( C ). Three-dimensional reconstruction ( D ).
Fig. 3
Fig. 3
Intraoperative view: distal end of the graft floating in the pseudoaneurysm sac, mimicking an “elephant trunk.”
See this image and copyright information in PMC

References

    1. Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968;23(04):338–339. - PMC - PubMed
    1. Kouchoukos N T, Wareing T H, Murphy S F, Perrillo J B.Sixteen-year experience with aortic root replacement. Results of 172 operations Ann Surg 199121403308–318., discussion 318–320 - PMC - PubMed
    1. Mookhoek A, Korteland N M, Arabkhani B. Bentall procedure: a systematic review and meta-analysis. Ann Thorac Surg. 2016;101(05):1684–1689. - PubMed
    1. Milano A D, Pratali S, Mecozzi G.Fate of coronary ostial anastomoses after the modified Bentall procedure Ann Thorac Surg 200375061797–1801., discussion 1802 - PubMed
    1. Sperandio M, Nicolò F, Fusco A, Bovio E, Raguso M, Simonetti G. Upward displacement of prosthetic aortic valved conduit after modified Bentall procedure for type A acute aortic dissection. J Adv Med Med Res. 2014;5(01):129–133.