Reoperation for Proximal and Distal Pseudoaneurysmal Formations of the Ascending Aorta with Aortic Regurgitation after an Ascending Aorta Replacement for Acute Type A Aortic Dissection

Koji Kawago＊	Takehito Mishima＊	Takashi Wakabayashi＊
Yuko Tosaka＊	Satoshi Nakazawa＊	Hiroshi Kanazawa＊

（Department of Cardiovascular Surgery, Niigata City General Hospital＊, Niigata, Japan）

We report a case of reoperation for proximal and distal pseudoaneurysmal formations of the ascending aorta with aortic regurgitation（AR）after an ascending aorta replacement for acute type A aortic dissection. The patient was a 69-year-old woman who had undergone ascending aorta replacement for acute type A aortic dissection six years previously. Subsequent development of pseudoaneurysms of the ascending aorta and aortic regurgitation were revealed by computed tomography and echocardiography respectively. We chose debranch Thoracic Endovascular Aortic Repair（TEVAR）with a staged approach. First, aortic valve replacement, patch closure of proximal pseudoaneurysmal formation, coronary artery bypass, and ascending aorta-axillary artery bypass were performed. Two weeks later, debranching and TEVAR were performed. Cardiac reoperation for proximal and distal pseudoaneurysmal formations of the ascending aorta with aortic regurgitation after an ascending aorta replacement is known to be high risk. Nevertheless we performed the operation safely in two-stage surgery.

 

Jpn. J. Cardiovasc. Surg. 46:177-181（2017）

Keywords：pseudoaneurysmal formations;aortic regurgitation;acute aortic dissection;postoperative complication;debranch TEVAR