A time bomb in the thorax: the giant ascending aortic aneurysm. Case report
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(2) 0651 6 A time_Fiore:-. 18-01-2012. 8:56. Pagina 25. er. na. zi on. al i. A time bomb in the thorax: the giant ascending aortic aneurysm. Case report. Fig. 3 - Computed tomography scan (sagittal view). Close relationship between the aneurysm and the sternum.. nt. Fig. 2 - Computed tomography scan (coronal view). Fusiform aspect of aneurysm.. Our case shows that the surgical treatment of a giant aortic aneurysm may be successful even in octogenarians. At present we consider that the femoral approach for the cardio-pulmonary bypass represents a surgical challenge, especially in older patients that can present severe peripheral vessel disease (1-3). Therefore we use to cannulate the right axillary artery and the femoral vein in case of ascending aneurysm involving the proximal aspect of the aortic arch.. Ed. iz io. ni I. The natural history of untreated thoracic aortic aneurysm indicates that incidence of death due to rupture or dissection is very high and size of aneurysm appear to be the most important predictor, therefore an emergent surgical treatment was performed. Before sternotomy, femoro-femoral bypass was established to decompress the aneurysm which shows close relationship with the sternum (Fig. 3). Using deep hypothermia and circulatory arrest, the replacement of the ascending aorta and hemiarch was performed with a Dacron graft. The postoperative course was uneventful and the patient was discharged on postoperative day 7.. Conclusion. References. rac Surg 2004;78(4):1285-9; discussion 1285-9. 3. Kamiya H, Kallenbach K, Halmer D, Ozsoz M, Ilg K, Lichtenberg A, Karck M. Comparison of ascending aorta versus femoral artery cannulation for acute aortic dissetion type A. Circulation 2009; 15,120 (11 suppl):S282-6.. ©. C. IC. 1. Lillehei CW, Cardozo RH. Use of median sternotomy with femoral artery cannulation in open cardiac surgery. Surg Gynecol Obstet 1959; 108:707-714. 2. Fusco DS, Shaw RK, Tranquilli M, Kops GS, Elefteriades JA. Femoral cannulation is safe for type A dissection repair. Ann Tho-. 25.
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