Work

Surgical Repair of Massive Ascending Aortic Pseudoaneurysm

Year: 2025

Type: article

Abstract: BACKGROUND: Surgical management of aortic pseudoaneurysm is a distinct challenge, requiring careful attention to cardiac and cerebral protection. CASE SUMMARY: A 58-year-old man presented with ascending aortic pseudoaneurysm in the setting of prior dissection repair, with active inflow from the pseudoaneurysm to the false lumen of the aortic arch. With cannulation of the axillary artery and femoral vein, direct cannulation of the right carotid artery for antegrade cerebral perfusion, and direct venting of the left ventricle, the brain and heart were protected prior to sternotomy, allowing for safe cooling and circulatory arrest upon disruption of the pseudoaneurysm. Zone 2 aortic arch replacement was completed, and the patient recovered well and was discharged to rehabilitation postoperatively. DISCUSSION: This report highlights the management considerations when approaching repair of a complex aortic pseudoaneurysm, including planning, cardiopulmonary bypass setup, and surgical execution. TAKE-HOME MESSAGE: This surgical approach may be considered by surgical teams for management of high-risk reoperative aortic surgery.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106161

Authors: Michael A. Catalano, Daniel Bazianos, Cecillia Chin, Nimesh D. Desai, Kendall M. Lawrence

Institutions: University of Pennsylvania, Thomas Jefferson University Hospital

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850