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
. 2024 Dec 31;32(4 Suppl 2):108-109.
doi: 10.5606/tgkdc.dergisi.2024.mep-12. eCollection 2024 Nov.

[MEP-12] Rare and Catastrophic Complication After Bentall Operation: Right Coronary Artery Button Pseudoaneursym Repaired with Modified Cabrol Technique

Nur Gizem Elipek  1 , İlknur Günaydın  1 , Seyhan Babaroğlu  1 , Şeref Alp Küçüker  1 , Ayşen Aksöyek  1
Affiliations

[MEP-12] Rare and Catastrophic Complication After Bentall Operation: Right Coronary Artery Button Pseudoaneursym Repaired with Modified Cabrol Technique

Nur Gizem Elipek et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

Coronary artery pseudoaneurysm is a rare but fatal complication that can be seen following the Bentall operation. Modified techniques have reduced these complications but they have not completely eliminated them. In this case report, we presented a 65-year-old female patient who underwent a Bentall procedure in 2012 and endovascular coil repair of a right coronary artery button pseudoaneurysm in 2016. Right femoral artery and vein cannulation was performed, and systemic cooling was started. Cardiopulmonary bypass was instituted, and the patient was cooled to 18°C. Deep hypothermic circulatory arrest was started, and resternotomy was performed (deep hypothermic circulatory arrest duration was 7 min). The aneurysm sac was opened. Of the coronary buttons the left main coronary artery orifice was not suitable for direct reimplantation to the new ascending graft, reimplantation was performed with the modified Cabrol technique using an 8-mm Dacron graft. The right coronary artery orifice was primarily closed, and bypass was performed on the Cabrol graft with a saphenous vein graft. The patient was rewarmed and weaned off cardiopulmonary bypass without complication. Intraoperative control fiberoptic bronchoscopy and transesophageal echocardiography showed that the trachea and pulmonary artery compression were completely eliminated. The patient was extubated on time during the intensive care course and made an uneventful recovery. Coronary button pseudoaneurysm complication after modified Bentall surgery requires urgent surgical repair. The modified Cabrol technique can be a lifesaver in such complications and redo cases. Although there are authors who recommend interventional methods first in this complication, we believe that early surgical intervention is more appropriate as it will become more complicated over time.

Keywords: Bentall procedure; coronary artery pseudoaneursym; coronary button pseudoaneurysm; modified Cabrol technique..

PubMed Disclaimer

Figures

Figure 1
Figure 1. Intraoperative image of the modified Cabrol technique.
Figure 2
Figure 2. Pseudoaneurysm compressing the right pulmonary artery and trachea.
Figure 3
Figure 3. Endovascular coil seen on fluoroscopy.
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;23:338–339. doi: 10.1136/thx.23.4.338. - DOI - PMC - PubMed
    1. Varela Barca L, Calderón Romero P, Sánchez-Aquino R, Donado Miñambres A, Hernández-Estefanía R, Sanz Mayordomo P, et al. Coronary pseudoaneurysm after Bentall-Bono intervention: A novel treatment to a rare surgery complication. J Cardiol Cases. 2022;26:157–160. doi: 10.1016/j.jccase.2022.04.005. - DOI - PMC - PubMed
    1. Kouchoukos NT, Marshall WG Jr, Wedige-Stecher TA. Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve. J Thorac Cardiovasc Surg. 1986;92:691–705. - PubMed
    1. Milano AD, Pratali S, Mecozzi G, Boraschi P, Braccini G, Magagnini E, et al. Fate of coronary ostial anastomoses after the modified Bentall procedure. Ann Thorac Surg. 2003;75:1797–1801. doi: 10.1016/s0003-4975(03)00015-8. - DOI - PubMed
    1. Celiento M, Ravenni G, Margaryan R, Ferrari G, Blasi S, Pratali S, et al. The modified Bentall procedure: A single-institution experience in 249 patients with a maximum follow up of 21. 5 years. J Heart Valve Dis. 2016;25:448–455. - PubMed

LinkOut - more resources