Aorto-Cutaneous Fistula and False Aneurysm of the Ascending Aorta Five Years after its Prosthetic Replacement for Stanford Type A Acute Aortic Dissection

Abstract

Aorto-cutaneous fistula and false aneurysm of the ascending aorta in patients who previously underwent Stanford Type A acute aortic dissection are rare and severe complications. Surgical correction remains a demanding challenge. In a case of false aneurysm rupture during redo sternotomy, selective cannulation of the right axillary and left carotid arteries allowed an efficient method of cerebral perfusion.

Key Words

Aortic dissection - Pseudo-aneurysm - Aorto-cutaneous fistula - Cerebral protection

^† These authors contributed equally to this work

• References

• 1 Mulder EJ, van Boeckel JH, Maas J, van den Akker PJ, Hermans J. Morbidity and mortality of reconstructive surgery of noninfected false aneurysms detected long after aortic prosthetic reconstruction. Arch Surg 1998; 133: 45-49 . DOI: 10.1001/archsurg.133.1.45
• 2 Razzouk A, Gundry S, Wang N, Heyner R, Sciolaro C, Van Arsdell G. , et al. Pseudoaneurysms of the aorta after cardiac surgery or chest trauma. Am Surg 1993; 59: 818-823 . PMID: 8256935
• 3 Sullivan K, Steiner R, Smullens S, Griska L, Meister S. Pseudoaneurysm of the ascending aorta following cardiac surgery. Chest 1988; 93: 138-143 . DOI: 10.1378/chest.93.1.138
• 4 Bachet JE, Termignon JL, Dreyfus G, Goudot B, Martinelli L, Piquois A. , et al. Aortic dissection prevalence, cause, and results of late reoperations. J Thorac Cardiovasc Surg 1994; 108: 199-205 . PMID: 8041167
• 5 Mohammadi S, Bonnet N, Leprince P, Kolsi M, Rama A, Pavie A. , et al. Reoperation for false aneurysm of the ascending aorta after its prosthetic replacement: surgical strategy. Ann Thorac Surg 2005; 79: 147-152 . DOI: 10.1016/j.athoracsur.2004.06.032
• 6 Sakurada T, Kazui T, Tanaka H, Komatsu S. Comparative experimental study of cerebral protection during aortic arch reconstruction. Ann Thorac Surg 1996; 61: 1348-1354 . DOI: 10.1016/0003-4975(96)00026-4
• 7 Kazui T, Kimura N, Yamada O, Komatsu S. Surgical outcome of aortic arch aneurysms using selective cerebral perfusion. Ann Thorac Surg 1994; 57: 904-911 . DOI: 10.1016/0003-4975(94)90201-1
• 8 Bachet J, Guilmet D. Brain protection during surgery of the aortic arch. J Card Surg 2002; 17: 115-124 . DOI: 10.1111/j.1540-8191.2002.tb01185.x