Cardiac Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Cardiothorac Surg. 2021 Dec 7;16(1):348. doi: 10.1186/s13019-021-01737-y.
Pseudoaneurysm of ascending aorta is a rare but serious complication of cardiovascular surgeries and it infrequently occurs in the normal prosthetic graft materials. We share our experience with an unusual case of ascending aorta Dacron graft pseudoaneurysm caused by a fractured sternal wire.
A 34-year-old man, known case of Marfan syndrome, with history of two prior aortic surgeries for aneurysm of ascending aorta, arch and thoracoabdominal aorta, presented with hemoptysis. The hemoptysis originated from an aortobronchial fistula secondary to a huge ascending aorta Dacron graft pseudoaneurysm. The graft erosion and subsequent pseudoaneurysm was caused by a fractured sternal wire. Surgical repair of the pseudoaneurysm was performed successfully and a Gore-tex patch was placed behind the sternum over the graft to prevent further direct contact of the wire and the graft.
Sternal wires can damage the adjacent vascular grafts and lead to fatal complications such as pseudoaneurysm formation. Thus, preventive measures such as using sternal bands and placing a covering layer between the sternal wires and aortic grafts are recommended in patients with dilated or replaced ascending aorta.
升主动脉假性动脉瘤是心血管手术的一种罕见但严重的并发症，在正常的人造移植物材料中很少发生。我们分享了一例由胸骨钢丝断裂引起的升主动脉涤纶移植物假性动脉瘤的罕见病例。
一名 34 岁男性，患有马凡综合征，曾因升主动脉、弓部和胸腹主动脉动脉瘤进行过两次主动脉手术，因咯血就诊。咯血源于升主动脉涤纶移植物巨大假性动脉瘤引起的支气管-主动脉瘘。移植物侵蚀和随后的假性动脉瘤是由胸骨钢丝断裂引起的。成功地对假性动脉瘤进行了手术修复，并在胸骨后面的移植物上放置了 Gore-tex 补丁，以防止钢丝和移植物进一步直接接触。
胸骨钢丝可损伤邻近的血管移植物，导致假性动脉瘤形成等致命并发症。因此，建议在升主动脉扩张或置换的患者中使用胸骨带，并在胸骨钢丝和主动脉移植物之间放置覆盖层，以预防此类并发症。
