Aortopulmonary fistula is an extremely rare complication of aortic dissection. We report a case of a chronic dissecting giant aneurysm with an aortopulmonary fistula. A 78-year-old woman experienced sudden onset chest pain and oppression. Chest X-ray showed ascending aortic and left ventricular enlargement and pulmonary congestion. Computed tomography (CT) confirmed the 100 mm ascending aortic aneurysm with dissection and aortopulmonary fistula. Operative repair was performed under profound hypothermic circulatory arrest with selective cerebral perfusion. The proximal and distal end were obliterated using a gelatin-resorcin-formaldehyde tissue glue and reinforced with a Teflon felt circumferential strip. The ascending aorta was replaced by a 30 mm coated Dacron vascular graft and the aortopulmonary fistula was closed with pledgeted vertical mattress suture. Postoperative CT showed a normally functioning vascular implant without any sign of aortopulmonary shunt or pulmonary artery stenosis.
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Int Heart J
September 2024
Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
Eur J Case Rep Intern Med
July 2024
Department of Internal Medicine, Reading Hospital, West Reading, USA.
Introduction: Aortic pseudoaneurysms are a type of contained rupture where most of the aortic wall is breached, leaving only a thin rim of the remaining wall or adventitia to hold the blood. This condition carries a high risk of rupture and potentially fatal complications. Typically, patients present with chest pain; haemoptysis can also occur, though rarely.
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May 2024
Cardiac Intensive Care Unit, San Raffaele University Hospital, Via Olgettina 60, 20132 Milan, Italy.
Background: The acquired communication between the aorta and the pulmonary artery is a rare and potentially life-threatening condition. Its diagnosis is challenging and may require a multimodality imaging approach.
Case Summary: A 67-year-old Caucasian man, admitted for acute respiratory failure unresponsive to medical therapy and non-invasive ventilation, was diagnosed with an aortopulmonary fistula (APF) complicating a pseudoaneurysm of the aortic root.
Eur Heart J Cardiovasc Imaging
December 2023
Cardiology Department, Hospital Universitario de La Princesa, Calle Diego de León 62, Madrid 28006.
Eur Heart J Case Rep
September 2023
Department of Cardiomyopathies and Aortic Diseases, Heart Institute (InCor) University of São Paulo, Dr Eneas de Carvalho Aguiar Avenue, number 44, São Paulo, 05403-900 São Paulo, Brazil.
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