Successful Endovascular Approach for Zone 0 Ascending Aortic Pseudoaneurysm as a Complication after Bentall Procedure

Tanıl Ozer, Ozge Altas Yerlikhan, Mustafa Mert Ozgur, Atakan Tekin, Mehmet Aksut, Sabit Sarikaya, Kaan Kirali

University of Health Sciences Kartal Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – A

Abstract

Introduction :Use of endovascular procedures for thoracic and abdominal aortic aneurysms is increased worldwide but it is not preffered much for ascending aorta. Surgical approaches preferred instead. We present our endovascular approach to ascending aortic pseudoaneurysm.

Case

48 years old female patient with history of Mitral valve replacement + aortic valve replacement 1 years ago and Bentall (with 32 no dacron graft) procedure 3 months after first surgery because of aortic paravalvular leak and ascending aortic aneurysm and finally surgical repair of ascending aortic pseudoaneurysm which is occurred 3 months after Bentall procedure referred to us with fatigue. She also had history of recurrent sternal dehiscence repair and prolonged sternal wound infection and healing process after these surgeries. Her hemoglobin value was 7 g/dl on CBC. We performed CT angiography and we diagnosed a new pseudoaneurysm through the distal suture line of graft. We decided to perform endovascular intervention instead of surgical approach and performed 32x52 mm succesful TEVAR to ascending aorta. There were no pseudoaneuryms on control CT angiography. Patient discharged from hospital 3 days after procedure.

Conclusion: Surgical intervention is gold standart procedure ascending aortic aneurysms and pseudoaneurysms. We preferred endovascular because patient has history of recurrent sternal dehiscence and prolonged sternal wound infection. As in this case endovascular approaches should be kept in mind beside surgical intervention.