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      Is Open Access

      Post-traumatic Aortopulmonary Fistula after Bentall Procedure

      case-report

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          Abstract

          Pseudoaneurysm complicated by aortopulmonary fistula (APF) after a Bentall procedure is extremely rare but potentially fatal, so timely diagnosis and treatment are critical. We present a subacute case of a post-traumatic APF which has had initial aspecific symptoms and later an acute worsening heart failure with chest pain not responding to medical treatment and requiring emergency surgery.

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          A technique for complete replacement of the ascending aorta.

          Eelco de Graaf, H BENTALL (1968)
          Article 0 comments Cited 129 times – based on 0 reviews     Review now
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            Endovascular stent grafting for ascending aorta repair in high-risk patients.

            Eric Roselli, Jahanzaib Idrees, Roy Greenberg … (2015)
            Standard treatment of ascending aortic pathology is open repair, but some patients are too high risk. Thoracic endovascular aortic repair (TEVAR) of the ascending aorta has been used as an alternative. Our objectives were to characterize patients, describe repair methods, and assess outcomes.
            Article 0 comments Cited 34 times – based on 0 reviews     Review now
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              Sixteen-year experience with aortic root replacement. Results of 172 operations.

              H Wareing, Peter Murphy, Nicholas Kouchoukos … (1991)
              During a 16-year interval ending in October 1990, 168 patients underwent 172 aortic root replacements. Thirty patients (18%) had Marfan syndrome. Annuloaortic ectasia (81 patients) and aortic dissection (63 patients) were the principal indications for operation. Twenty-seven patients (16%) had previous operations on the ascending aorta or aortic valve. The hospital mortality rate was 5% and the duration of cardiopulmonary bypass was the only significant independent predictor of early death (p = 0.017). Major modifications in technique were made in 1981, when the inclusion/wrap technique employing a composite graft (used in the first 105 procedures) was abandoned in favor of an open technique (used in 51 procedures), and in 1988, when aortic allografts and pulmonary autografts were introduced for selected conditions (reoperations, dissection, endocarditis, isolated aortic valve disease) in 16 patients. The mean duration of follow-up was 81 months. Forty-six patients were followed for more than 10 years. The actuarial survival rate was 61% at 7 years and 48% at 12 years. No significant difference in survival rate was observed between the patients with annuloaortic ectasia and aortic dissection, or between the inclusion/wrap and open techniques. However the frequency of pseudoaneurysm formation at suture lines and the frequency of reoperations on the ascending aorta and aortic valve were less with the open technique. The actuarial freedom from thromboembolism for the 152 patients with prosthetic valves was 82% at 12 years. One early and one late death occurred among the 16 patients with allograft or autograft root replacement. Anticoagulant therapy was not used in these patients and no thromboembolic episodes occurred in the follow-up period (mean, 7 months). The satisfactory results observed with extended follow-up support the continued use of the composite graft technique as the preferred method of treatment for patients with annuloaortic ectasia, persistent aneurysms of the sinuses of Valsalva following previous operations, and for patients with ascending aortic dissection who require aortic valve replacement. The availability of aortic root allografts and the perfection of techniques for safe implantation of the autologous pulmonary root into the aortic position have broadened the indications for aortic root replacement.
              Article 0 comments Cited 33 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cardiovasc Echogr
                Journal ID (iso-abbrev): J Cardiovasc Echogr
                Journal ID (publisher-id): JCE
                Title: Journal of Cardiovascular Echography
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 2211-4122
                ISSN (Electronic): 2347-193X
                Publication date (Print): Jan-Mar 2020
                Publication date (Electronic): 13 April 2020
                Volume: 30
                Issue: 1
                Pages: 29-32
                Affiliations
                [1]Department of Cardiology and Cardiovascular Physiopathology, University of Perugia, Perugia, Italy
                [1 ]Department of Cardiology, Perugia Hospital, Perugia, Italy
                [2 ]Department of Cardiac Surgery, Perugia Hospital, Perugia, Italy
                Author notes
                Address for correspondence: Dr. Daniela Izzo, University of Perugia, P.le Menghini 1, Perugia 06129, Italy. E-mail: danismile89@ 123456gmail.com
                Article
                Publisher ID: JCE-30-29
                DOI: 10.4103/jcecho.jcecho_5_20
                PMC ID: 7307618
                SO-VID: b991c331-a829-4511-b5d7-a548a32edf40
                Copyright © Copyright: © 2020 Journal of Cardiovascular Echography
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 14 January 2020
                Date revision received : 25 February 2020
                Date accepted : 09 March 2020
                Categories
                Subject: Case Report

                Keywords: aortopulmonary fistula,bentall procedure,computed tomography,echocardiography,periprosthetic false aneurysm
                Data availability:
                Keywords: aortopulmonary fistula, bentall procedure, computed tomography, echocardiography, periprosthetic false aneurysm

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