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Case Reports
Chronic False Aneurysm after a Healed Rupture of the Aortic Isthmus: TEVAR, Hybrid Surgery, or Open Arch Repair?
- Christophe Nizet, Hendrik Van Damme, Evelyne Boesmans, Jean-Paul Lavigne, Etienne Creemers, and Jean-Olivier Defraigne.
- Department of Cardiovascular Surgery, University Hospital Sart Tilman, Liège, Belgium. Electronic address: cnizet@student.ulg.ac.be.
- Ann Vasc Surg. 2016 Feb 1; 31: 205.e11-6.
AbstractWe report a case of post-traumatic chronic false aneurysm of the aortic isthmus in a 34-year-old man who had been involved in a car accident 10 years earlier. An initial chest X-ray demonstrated a calcified mass in the upper mediastinum and computed tomography scan revealed a false aneurysm of the aortic isthmus arising above the left subclavian artery. Partial covered rupture of the aorta is not always easy to diagnose and can remain clinically silent in a polytrauma patient. The duration from rupture to false aneurysm formation may extend over many years. This chronic lesion can be managed by surgery, by an endovascular procedure, or by a combined procedure. This case report highlights the current therapeutic approach. A debranching procedure was done in view of a secondary exclusion of the huge false aneurysm by a stent graft. Unfortunately, the false aneurysm ruptured during the procedure and a replacement of the aortic arch and the isthmus under total circulatory arrest was successfully done. The patient was doing well at 9-month follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.
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