CASE REPORTS   

International Angiology 2003 March;22(1):88-91

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Off-pump reconstruction of pseudoaneurysm of the descending thoracic aorta

Shindo S., Kojima A., Tada Y., Ogata K., Kobayashi M.

2nd Department of Surgery, Yamanashi Medical University, Yamanashi, Japan

We ­report 2 cases of post­op­er­a­tive pseu­do­aneu­rysm of the descend­ing tho­rac­ic aorta, ­repaired suc­cess­ful­ly by tem­po­rary ­bypass graft with­out extra­cor­po­real ­bypass. One ­patient pre­sent­ed with a large recur­rent pseu­do­aneu­rysm that devel­oped 30 years after liga­tion of a pat­ent duc­tus arte­ri­o­sus. The other ­patient pre­sent­ed with a pseu­do­aneu­rysm 18 years after tho­rac­ic aor­tic recon­struc­tion for a trau­mat­ic aneu­rysm. In both cases, a tem­po­rary ­bypass graft was creat­ed from a major ­branch of the aor­tic arch to the femo­ral ­artery prior to defin­i­tive recon­struc­tion. The post­op­er­a­tive ­course was uncom­pli­cat­ed by organ dys­func­tion or neu­ro­log­ic def­i­cit. Crea­tion of a tem­po­rary ­bypass graft can avoid the need for car­di­o­pul­mo­nary ­bypass in select­ed ­patients. By avoid­ing hep­ar­in use, blood loss is ­decreased, espe­cial­ly when dense pul­mo­nary adhe­sions from pre­vi­ous sur­gery are ­present.