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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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The Journal of Cardiovascular Surgery 2000 Agosto;41(4):607-12

VASCULAR PAPERS 

 CASE REPORTS

Management of aberrant subclavian artery aneurysms

Myers J. L., Gomes M. N.

From the Depart­ment of Sur­gery George­town Uni­ver­sity Med­ical ­Center, Wash­ington, DC, USA

An aber­rant sub­cla­vian ­artery is the ­most ­common con­gen­ital ­anomaly of the ­aortic ­arch. Aneu­rysms of ­these ves­sels are rel­a­tively ­rare ­lesions. A ­high clin­ical sus­pi­cion ­must be main­tained in ­patients ­with an ­abnormal med­i­as­tinum on ­chest X-ray, espe­cially in ­patients ­with dys­phagia, ­dyspnea, or ­upper ­extremity ­ischemic symp­toms not oth­er­wise ­explained. Poten­tially dis­as­trous com­pli­ca­tions, ­including spon­ta­neous rup­ture and per­fo­ra­tion ­into the esoph­agus may ­occur, and are invar­i­ably ­fatal. We ­present the ­case of an asymp­to­matic 72-­year-old ­male ­with an aber­rant ­right sub­cla­vian ­artery aneu­rysm pre­senting as a med­i­as­tinal ­mass on rou­tine ­chest X-ray. ­Repair was by aneu­rys­mec­tomy ­through a ­left thor­a­cotomy and ­right ­common ­carotid ­artery to sub­cla­vian ­artery ­bypass via ­median ster­notomy ­with res­o­lu­tion of his symp­toms. We ­reviewed 74 ­cases in the Eng­lish lit­er­a­ture to February 1998. The per­ti­nent ­anatomy is dis­cussed and ­trends in sur­gical treat­ment are iden­ti­fied. ­Recent agree­ment on the sur­gical ­approach and ­choice of revas­cu­lar­iza­tion ­appears to ­exist, but ­advances in diag­nostic and inter­ven­tional radio­logic capa­bil­ities ­have ­increased the ­number of asymp­to­matic ­lesions encoun­tered and may ­alter the treat­ment of ­this ­lesion in the ­near ­future.

lingua: Inglese


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