Varela Barca Laura, Calderón Romero Pilar, Sánchez-Aquino Rosa, Donado Miñambres Alicia, Hernández-Estefanía Rafael, Sanz Mayordomo Petra, Aldámiz-Echevarría Gonzalo
Cardiac Surgery Department, Hospital Fundación Jiménez Díaz, Madrid, Spain.
Cardiology Department, Hospital Rey Juan Carlos, Madrid, Spain.
J Cardiol Cases. 2022 May 21;26(2):157-160. doi: 10.1016/j.jccase.2022.04.005. eCollection 2022 Aug.
We present a rare case of a coronary pseudoaneurysm after a Bentall-Bono procedure. During a routine follow-up computed tomography scan, a pseudoaneurysm located between the aorta and the proximal portion of the right coronary artery was diagnosed. Contrast extravasation was observed with partial thrombosis of the pseudoaneurysm. Coronary angiography and intravascular ultrasound were performed showing the point of contrast extravasation dependent of the right coronary artery in its proximal portion. An angioplasty procedure was performed sealing the pseudoaneurysm with the implantation of a covered stent. After an uneventful postoperative follow-up, the patient was discharged home.
The development of a coronary artery pseudoaneurysm (CAP) after complex cardiac surgeries, like Bentall-Bono procedure, could be a life-threatening condition. The possible derived complications of CAP are rupture, compression of surrounding structures, or coronary ischemia.Although surgical approach to a CAP may have an extremely high surgical risk, most of the cases require a complex surgical repair. We describe a novel possible treatment option by angioplasty and sealing of the CAP with the implantation of a covered stent.
我们报告了一例在Bentall-Bono手术后发生冠状动脉假性动脉瘤的罕见病例。在一次常规随访计算机断层扫描中,诊断出一个位于主动脉和右冠状动脉近端之间的假性动脉瘤。观察到造影剂外渗,假性动脉瘤有部分血栓形成。进行了冠状动脉造影和血管内超声检查,显示造影剂外渗点位于右冠状动脉近端。实施了血管成形术,通过植入覆膜支架封闭假性动脉瘤。经过平稳的术后随访,患者出院回家。
在诸如Bentall-Bono手术等复杂心脏手术后发生冠状动脉假性动脉瘤(CAP)可能是一种危及生命的情况。CAP可能引发的并发症包括破裂、压迫周围结构或冠状动脉缺血。尽管对CAP进行手术治疗可能具有极高的手术风险,但大多数病例需要进行复杂的手术修复。我们描述了一种通过血管成形术并用覆膜支架植入封闭CAP的新型可能治疗方案。