| Successful Surgical Management
of an Aortic Arch Aneurysm with an Aorto-Pulmonary Artery Fistula |
(First Department of Surgery, Yamaguchi University
School of Medicine, Ube, Japan and Miyamoto Clinic*, Kudamatsu,
Japan)
| Kazuhiro Suzuki |
Kimikazu Hamano |
Sayaka Hanada |
| Masanori Hayashi |
Bunngo Shirasawa |
Hiroshi Itou |
| Akihito Mikamo |
Masaki Miyamoto* |
|
|
A 72-year-old woman had undergone
resection and graft replacement of the proximal ascending aorta
for a DeBakey type II aortic dissection. She presented again
7 years later with progressive dyspnea and a cough. Computed
tomography confirmed an aortic arch aneurysm and Doppler echocardiography
demonstrated aortopulmonary shunting. Cardiac catheterization
revealed a fistula between the aorta and pulmonary artery with
a 54.3% left-to-right shunt and a Qp/Qs of 2.19. Operative repair
was performed under profound hypothermic circulatory arrest with
selective cerebral perfusion. The aortopulmonary artery fistula
was closed from within the aneurysm using an equine pericardial
patch and the transverse aortic arch was resected and replaced
with a graft. The patient recovered uneventfully and was discharged
on postoperative day 43.
Jpn. J. Cardiovasc. Surg. 32：137 -140 (2003) |
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