Key result
Graft needle-hole oozing triggers massive aortic root pseudoaneurysm 20 months after modified Bentall procedure.
Why the study?
A rare case of a giant pseudoaneurysm caused by needle hole bleeding from an artificial graft after a modified Bentall procedure was encountered.
Case Report (n=1)
No
This case highlights the rare complication of a giant pseudoaneurysm forming due to oozing bleeding from an artificial graft needle hole in the late phase after a modified Bentall procedure.
Alerts clinicians to rare late graft needle-hole bleeding in post-Bentall pseudoaneurysms; extends known late complications after modified Bentall.
症例は79歳，女性．65歳時に急性A型大動脈解離にて弓部置換術が施行され，翌年に胸腹部解離性大動脈瘤に対し胸部ステントグラフト内挿術とYグラフト置換術が施行された．73歳時に維持透析導入となり，77歳時に大動脈基部巨大仮性瘤および僧帽弁閉鎖不全症を認め，大動脈基部置換術（modified Bentall手術）および僧帽弁形成術を施行した．退院時に異常は認められなかったが，大動脈基部置換術後1年のCT検査にて大動脈基部周囲に仮性瘤を認めた．当時は明らかな胸部症状を認めず，年齢やADLを考慮したうえで経過観察されたが，術後1年8カ月頃より透析中の胸痛や右季肋部痛を自覚するようになった．大動脈基部仮性瘤拡大と冠動脈造影検査で右冠動脈の高度狭窄を認めたため，手術を行った．手術では人工血管針穴からのoozing性出血を認めた．大動脈基部置換術後遠隔期に人工血管針穴出血により巨大仮性瘤を形成した稀な1例を経験した．
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Murayama et al. (2017) conducted a case report in Aortic root pseudoaneurysm (n=1). Redo operation for pseudoaneurysm repair was evaluated on Surgical findings and outcome. A rare case of a huge aortic root pseudoaneurysm was found to be caused by oozing from the needle hole of the artificial graft 20 months after a modified Bentall procedure.
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