An Elderly Case of Ruptured Aortic Arch Aneurysm with Hemorrhagic Cardiac Tamponade

(Department of Cardiothoracic Surgery, Dokkyo Medical University, Tochigi, Japan)

Yasuyuki Yamada Yoshihiko Mochizuki Yoshiei Shimamura
Kunihiro Eda Ikuko Shibasaki Yuhou Inoue
Shinichiro Miyoshi
An 82-year-old man was taken to a local clinic following the occurrence of syncope. Chest roentgenography and computed tomography (CT) findings led to a suspicion of a ruptured aortic aneurysm, and the patient was immediately transferred to our hospital. Upon admission, his consciousness was clear and blood pressure was 74/47mmHg. Enhanced chest CT images demonstrated pericardial effusion and a saccular aneurysm with a maximum diameter of 5cm, which was associated with a thrombus in the distal aortic arch. An emergency operation was performed under a diagnosis of a ruptured distal aortic arch aneurysm and hemorrhagic cardiac tamponade. During the procedure, a hole was found in the lesser curvature of the aneurysm, which had directly ruptured into the pericardial space, and a graft replacement of the aortic arch was performed using selective cerebral perfusion. The patient was discharged 19 days after surgery without any postoperative complications.
@Jpn. J. Cardiovasc. Surg. 36: 153-156 (2007)