Symptomatic Distal Anastomotic Pseudo-aneurysm After the Bentall Procedure Successfully Treated by Supra-aortic Trunk Debranching and Zone 0 Thoracic Endovascular Aneurysm Repair

Right Coronary Artery Button Pseudoaneurysm After the Modified Bentall Procedure

Anastomoses of the coronary buttons are the Achilles' heel of the modified Bentall procedure (MBP) for the repair of the aortic root and ascending aorta. We present a rare case of post-MBP right coronary artery button pseudoaneurysm in a 30-year-old man. The contained leak, attributed to a pseudoknot in the polypropylene suture, was visualized via computed tomography angiography and transesophageal echocardiogram and repaired under deep hypothermic circulatory arrest.

Abdominal Stent-Graft Treatment of Ascending Aortic Pseudoaneurysm Following Transcatheter Aortic Valve Implantation

An ascending aortic pseudoaneurysm is a potentially lethal complication in aortic procedures. We present a hybrid approach using surgical innominate artery access and the endovascular insertion of an abdominal stent-graft extension to successfully treat a zone 0 ascending aortic pseudoaneurysm in a patient with a prior valve-in-valve transcatheter aortic valve implantation.

Case Report: Ascending Aortic Pseudo-Aneurysm Following Ventricular Septal Defect Repair in a 4-Year-Old Girl

Pseudo-aneurysm is a fatal disease, and the main cause of death is massive hemorrhage secondary to the rupture of the aneurysm. This case report aims to evaluate the effects of pseudo-aneurysm excision procedure on the disease. A 4-year-old girl was readmitted on the 20th day after ventricular septal defect (VSD) closure procedure with a high fever of 40°C; aortic pseudo-aneurysm was suspected based on a spherical cystic echo (82 × 76 mm) of the ascending aorta which was detected by ultrasonic cardiogram, and the diagnosis was confirmed by an aortic computed tomograph angiography (CTA) examination and intraoperative findings. Treatment included emergency pseudo-aneurysm excision procedure and antibiotic therapy. The aortic pseudo-aneurysm was surgically removed under deep hypothermia and circulatory arrest. Antibiotics were applied according to the bacterial culture results. The pseudo-aneurysm was excised successfully, and the patient achieved a good recovery. Our case suggests that the postoperative ascending aortic pseudo-aneurysm was probably due to inappropriate purse-string suture and/or local or systematic infection, so extra precautions should be taken to avoid this life-threatening complication.