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PubMed · 12632931

[False aneurysms after button-Bentall procedure].

Paul Urbanski·Grzegorz Grudzień·Witold Dinstak·Reiner Schmitt·Bartłomiej Guzik·Jerzy Sadowski
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Abstract

Between January 1995 and December 2000, 222 consecutive patients underwent complete aortic root replacement in the Department of Cardiovascular Surgery of the Hertz- und Gefaess- Klinik- Bad Neustadt (Germany). At the exception of 2 cases, all patients received the modified Bentallde Bono procedure with total excision of the ascending aorta and direct reimplantation of the coronary ostia using button technique. During the follow-up period of up to 6 years in 3 patients, a periprosthetic aneurysm was diagnosed. In two patients with clinical symptoms and a fistula between the prosthetic lumen and the spurium aneurysm, a reoperation was performed. Due to the complete absence of clinical symptoms or a fistula connecting the prosthesis and the aneurysm or progress in size of the aneurysm during the follow-up period the third patient was treated conservatively. The choice of proper treatment of this complication is difficult and should be based on continuous investigation of clinical symptoms and various technical examinations.

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Aneurysm, FalseAortic AneurysmBlood Vessel Prosthesis ImplantationFalse Negative ReactionsFemaleHeart Valve Prosthesis ImplantationHumansMaleMiddle AgedTime FactorsTreatment OutcomeCase ReportsEnglish AbstractJournal Article

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Paul Urbanski, Grzegorz Grudzień, Witold Dinstak, Reiner Schmitt, Bartłomiej Guzik, Jerzy Sadowski. 2002. [False aneurysms after button-Bentall procedure].. https://pubmed.ncbi.nlm.nih.gov/12632931/

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Iatrogenic hepatic artery pseudoaneurysms: an uncommon complication after hepatic, biliary, and pancreatic procedures.

Hepatic artery pseudoaneurysms are uncommon but potentially lethal complications of hepatic, biliary, and pancreatic interventions. To enhance our knowledge about these pseudoaneurysms, we reviewed our institution's experience with the management of these lesions. We reviewed the literature on 136 cases of hepatic artery pseudoaneurysms as well as our experience with 17 patients (excluding patients who were post-transplantation or had suffered abdominal trauma). The causes, pathogenesis, and clinical features were analyzed. Ten women and seven men developed hepatic artery pseudoaneurysms after undergoing hepatic (65%), biliary (30%), or pancreatic procedures (5%). The mean time between initial intervention and diagnosis was 5.7 months (range 7 days-38 months). Rupture occurred in 13 patients (76%). Mean pseudoaneurysm size was 1.9 cm (range 0.7-4 cm). Embolization was successful in 12 of 14 patients (86%). Four patients (24%), including the two who failed embolization, required operative intervention. Postoperative mortality was 25% while postembolization mortality was 14%. One patient was observed, and the aneurysm thrombosed at 72 months follow-up. Mean follow-up was 48 months (range 1-184 months) for 13 of the 14 survivors (93%) (1 patient was lost to follow-up) without any clinical sequela. Hepatic artery pseudoaneurysms are rare. Rupture is common and occurred in 76% of patients. For both ruptured and nonruptured cases angiography with embolization of the pseudoaneurysm is safe and effective. Operative intervention should be reserved for patients for whom embolization fails or for whom it is not feasible.

Aneurysm, False↗