Mitsuoka Hiroki, Orimoto Yuki, Arima Takahiro, Ishiguchi Tsuneo, Ishibashi Hiroyuki
Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.
Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan.
Vasc Endovascular Surg. 2020 Nov;54(8):741-746. doi: 10.1177/1538574420945068. Epub 2020 Jul 30.
Pseudoaneurysms that develop after surgical repair of a patent ductus arteriosus (PDA) are more likely to rupture, but open surgery including a repeat thoracotomy would be highly invasive. We report 2 cases of thoracic endovascular aortic repair (TEVAR) for such pseudoaneurysms.
METHODS/RESULTS: A 59-year-old woman who underwent PDA surgical ligation at 13 years of age presented with sudden hemoptysis. She was diagnosed with a ruptured distorted pseudoaneurysm sized 26 mm; emergency TEVAR was performed. A 23-year-old woman with a history of Down syndrome, endocardial cushion defect, and PDA underwent 2 thoracotomy surgeries including PDA ligation. During a medical checkup, an abnormal shadow was detected on chest radiography. She was diagnosed with a 15-mm pseudoaneurysm after PDA surgical repair; TEVAR was performed. In both cases, the postoperative course was uneventful.
To the best of our knowledge, this is the first report of emergency TEVAR for ruptured pseudoaneurysms after PDA ligation. Thoracic endovascular aortic repair is an important therapeutic option for such cases as it eliminates the need for repeat thoracotomy.
