A Case of Anastomotic Pseudoaneurysm at an Anastounosis between Two Woven Dacron Prostheses Following Aortic Arch Replacement.

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The possibility of anastomotic pseudoaneurysms as a life-threatening complication following prosthetic graft replacement for an aneurysmal disease or an arterial occlusive disease is well known. However the pseudoaneurysm at an anastomosis between two prostheses is rarely reported. We present a successful surgical treatment for an anstomotic pseudoaneurysm between two prostheses. A 75-year-old man underwent total arch replacement for a true aortic arch aneurysm with the aid of selective cerebral perfusion five years previously. The graft used was a composite prosthesis consisting of 26mm woven Dacron graft for the aortic arch to which a hand-made three-tributary graft was sutured for major three arch vessels. An anastomotic pseudoaneurysm at an anastomotic site between the 26mm graft and a tributary graft was suspected on a chest CT and then differentially diagnosed by aortography. The anastomotic pseudoaneurysm was surgically resected and the anastomosis was repaired with 3-0 polypropylene continuous sutures with the aid of hypothermic circulatory arrest. Anastomotic aneurysm can occur only between a native vessel and a prosthesis but also between two prostheses. Therefore we should make periodical examinations such as CT after prosthetic graft replacement.
特定非営利活動法人日本心臓血管外科学会の論文