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You are here: Contents > 2012 > Volume 21 Number 4 July 2012 > MISCELLANEOUS > Aortopulmonary Fistula after a Modified Bentall Procedure

Aortopulmonary Fistula after a Modified Bentall Procedure

Gabriele Ferrari, Gerardo Anastasio, Massimiliano Bianchi, Giovanni Scioti, Fabio Guarracino, Uberto Bortolotti

Section of Cardiac Surgery and Division of Anesthesia, Cardiac Thoracic and Vascular Department and Division of Radiology, University Hospital, Pisa, Italy

A 68-year-old man presented with aortic pseudoaneurysm and aortopulmonary fistula, due to dehiscence of the left coronary button anastomosis, at three months after surgery for acute aortic dissection using a composite conduit. At reoperation, the pulmonary trunk was repaired by direct suture and the coronary ostial anastomosis with single sutures, reinforced with pericardial pledgets from inside the aortic graft. Aortopulmonary fistula due to pseudoaneurysm formation is an extremely rare complication of operations on the proximal aorta. Furthermore, pseudoaneurysm caused by dehiscence of a coronary anastomosis complicated by an

aortopulmonary fistula, as in the present case, has been previously reported only twice. Patients with acute aortic dissection, due to tissue fragility, appear particularly prone to develop such complications, which can occur even in the early postoperative period. Therefore, after the repair of acute aortic dissection, particularly when the insertion of a composite conduit is required, continuous follow up is mandatory for the early detection of this rare, but potentially lethal, complication.

The Journal of Heart Valve Disease 2012;21:505-508

Aortopulmonary Fistula after a Modified Bentall Procedure

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