Download PDF
CC BY 4.0 · Aorta (Stamford) 2022; 10(06): 304-307
DOI: 10.1055/s-0042-1757796
Case Report

The Secret behind Extreme Hypoxia Tolerance: A “Slow-Growth” Thoracoabdominal Aneurysm

Carlo Olevano 
1   Division of Cardiac Surgery, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
,
Giuliano Gagliardi
2   Division of Cardiac Imaging, Department of Radiology, S.G. Moscati Hospital, Avellino, Italy
,
Mollo Antonio
1   Division of Cardiac Surgery, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
,
Santaniello Eugenio
1   Division of Cardiac Surgery, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
,
Loris Flora
3   Division of Vascular Surgery, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
,
Emilio Di Lorenzo
4   Division of Cardiology, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
,
Brenno Fiorani
1   Division of Cardiac Surgery, Department of Cardiovascular Surgery, S.G. Moscati Hospital, Avellino, Italy
› Author Affiliations Funding Funding received from the Serom Medical Technology.
› Further Information
   Permissions and Reprints

Abstract

A 61-year-old man presented to our institution complaining of back pain. Breathing was comfortable. An arterial blood gas showed extreme hypoxia causing chronic respiratory alkalosis. Further investigations revealed aneurysmal dilatation of the ascending aorta and the Crawford Type II thoracoabdominal aneurysm, with compression of both the left main bronchus and the right pulmonary artery. The patient was managed with a two-stage hybrid surgical approach comprising total arch replacement using the frozen elephant trunk technique followed by endovascular repair.

Keywords

thoracoabdominal aneurysm - frozen elephant trunk - tracheobronchomalacia - extreme hypoxemia


Publication History

Received: 14 November 2021

Accepted: 06 July 2022

Article published online:
20 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Boyd LJ. A study of four thousand reported cases of aneurysm of the thoracic aorta. Am J Med Sci 1924; 168: 654
    CrossrefPubMedGoogle Scholar
  • 2 Yacoub MH, Braimbridge MV, Gold RG. Aneurysm of the ascending aorta presenting with pulmonary stenosis. Thorax 1966; 21 (03) 236-239
    CrossrefPubMedGoogle Scholar
  • 3 Gilbert-Kawai ET, Milledge JS, Grocott MP, Martin DS. King of the mountains: Tibetan and Sherpa physiological adaptations for life at high altitude. Physiology (Bethesda) 2014; 29 (06) 388-402
    PubMedGoogle Scholar
  • 4 Grocott MP, Martin DS, Levett DZ, McMorrow R, Windsor J, Montgomery HE. Caudwell Xtreme Everest Research Group. Arterial blood gases and oxygen content in climbers on Mount Everest. N Engl J Med 2009; 360 (02) 140-149
    CrossrefPubMedGoogle Scholar
  • 5 Murgu S, Colt H. Tracheobronchomalacia and excessive dynamic airway collapse. Clin Chest Med 2013; 34 (03) 527-555
    CrossrefPubMedGoogle Scholar
  • 6 Chen Q, Langton-Hewer S, Marriage S. et al. Influence of tracheobronchomalacia on outcome of surgery in children with congenital heart disease and its management. Ann Thorac Surg 2009; 88 (06) 1970-1974
    CrossrefPubMedGoogle Scholar
  • 7 Wright CD, Mathisen DJ. Tracheobronchoplasty for tracheomalacia. Ann Cardiothorac Surg 2018; 7 (02) 261-265
    CrossrefPubMedGoogle Scholar
  • 8 Abe T, Kamikubo Y, Taneichi T. et al. Right heart failure secondary to compression of the right pulmonary artery by a large proximal aortic aneurysm. Circulation 2013; 128 (14) 1588-1589
    CrossrefPubMedGoogle Scholar