Huge Pseudoaneurysm due to the Needle Hole of the Artificial Graft in the Bentall Procedure

Koh Murayama	Hirotaka Watanuki	Masaho Okada
Yasuhiro Futamura	Katsuhiko Matsuyama

（Department of Cardiovascular Surgery, Aichi Medical University, Aichi, Japan）

A 79-year-old woman complained of chest pain during hemodialysis. At 65 years of age, she underwent total arch replacement for acute aortic dissection. The following year, she underwent thoracic endovascular aortic repair and Y-graft replacement of a thoracoabdominal aortic aneurysm. Since the age of 73 years, she has been on hemodialysis for chronic renal failure. At 77 years of age, she underwent a modified Bentall procedure and mitral valve annuloplasty for a huge pseudoaneurysm at the aortic root and for mitral regurgitation. One year after the surgery, computed tomography（CT）showed a pseudoaneurysm around the aortic root. Although asymptomatic at the time of her follow-up visit, she developed chest pain during hemodialysis 20 months following the Bentall procedure. CT revealed progressive dilatation of the aortic root pseudoaneurysm. Coronary angiography showed severe stenosis of the right coronary artery. During the redo operation, findings indicated the presence of oozing type of bleeding from the needle hole from the previous artificial graft. We experienced a rare case of a huge aortic root pseudoaneurysm due to oozing from the needle hole at the artificial graft.

 

Jpn. J. Cardiovasc. Surg. 46:35-38（2017）

Keywords：Bentall procedure;pseudoaneurysm;hemodialysis