CASE REPORT
Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 320-323

Management of intact giant fusiform aneurysm of distal aortic arch with impeding risk of rupture using midline sternotomy


1 Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B. J. Medical College), New Civil Hospital Campus, Ahmadabad, Gujarat, India
2 Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center, Ahmadabad, Gujarat, India

Correspondence Address:
Devvrat Desai
Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B. J. Medical College), New Civil Hospital Campus, Ahmadabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_22_19

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Aneurysm of the distal aortic arch is routinely repaired using left thoracotomy. Here, we are reporting an unusual case of intact giant fusiform aneurysm of the distal aortic arch with managed successfully using midline sternotomy. A 54-year-old gentleman presented with progressive dyspnea and chest pain in the New York Heart Association Class IV. He was diagnosed to have intact giant (11 cm × 11.5 cm × 12 cm) fusiform aneurysm of the distal aortic arch extending up to proximal descending thoracic aorta resulting in the displacement of trachea toward the right and left main bronchus inferiorly with underlying lung collapsed. The patient underwent distal arch replacement through midline sternotomy under deep hypothermic circulatory arrest with continuous selective antegrade cerebral perfusion using the right axillary artery and right femoral artery cannulation. The arch was replaced using 28-mm collagen impregnated, woven polyester graft. He remained stable postoperatively and was discharged on the 10th postoperative day.


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