J Heart Stroke | Volume 4, Issue 1 | Case Report | Open Access

Management of Large Fusiform Aneurysm of Distal Aortic Arch with Contained Rupture Using Midline Sternotomy: A Case Report

Devvrat Desai*, Jignesh Kothari and Bhavin Bhrambhatt

Department of Cardiovascular and Thoracic Surgery, U N Mehta Institute of Cardiology and Research Center, India

*Correspondance to: Devvrat Desai 

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Abstract

Aneurysm of distal aortic arch is routinely repaired using left thoracotomy. Very large aneurysm can present as contained rupture making this approach highly unsafe. Here, we are reporting an unusual case of large fusiform aneurysm of distal aortic arch with contained rupture managed successfully using mid-line sternotomy. A 54 year gentleman presented with progressive dyspnoea and chest pain in NYHA class 4 over a period of two to three years. He was diagnosed to have large (11 cm × 11.5 cm × 12 cm) fusiform aneurysm of distal aortic arch extending up to proximal descending thoracic aorta with contained rupture resulting in displacement of trachea towards right & left main bronchus inferiorly with underlying lung collapsed. The patient underwent distal arch replacement via mid-line sternotomy under Deep Hypothermic Circulatory Arrest with continuous Selective Antegrade Cerebral Perfusion using right axillary artery and right femoral artery cannulation. The arch was replaced using 28 mm collagen impregnated, woven polyester graft. He remained stable in post-operative period & was discharged on tenth post-operative day.

Keywords:

Distal aortic arch; Aortic aneurysm; Contained aupture; Saccular aneurysm; Fusiform aneurysm; Aortic arch replacement

Citation:

Desai D, Kothari J, Bhrambhatt B. Management of Large Fusiform Aneurysm of Distal Aortic Arch with Contained Rupture Using Midline Sternotomy: A Case Report. J Heart Stroke. 2019; 4(1): 1054.

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