TITLE:
Pseudoaneurysm of Ascending Aorta with Extrinsic Compression of Left Main Coronary Artery
AUTHORS:
Kumar Aditya, Rohit Kumar, Harpreet Singh Minhas
KEYWORDS:
Pseudoaneurysm, Aorta, Cardiopulmonary Bypass, Circulatory Arrest
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.6 No.3,
March
29,
2016
ABSTRACT: Pseudoaneurysm of ascending aorta carries high mortality and morbidity due to adhesions and
compression over surrounding structures. It occurs either after some form of injury to aorta or
after infectious pathology. Spontaneous pseudoaneuryms are very rare as are the extrinsic compression
of left main coronary artery. We are presenting a case with both of these rare ties. Patient
was a female of middle age presented with cough and a past history of treated pulmonary tuberculosis
12 years before. During evaluation by X-ray, CECT is a large pseudoaneurysm of ascending
aorta with oval defect in posterior wall above sinotubular junction. It was compressing 90% of the
left main coronary artery, occluding 100% of the right pulmonary artery with formation of collaterals
to it from surrounding arteries. Active tuberculosis and syphilis were ruled out. Patient underwent
excision of pseudoaneurysm, replacement of ascending aorta by Dacron graft and coronary
artery bypass under TRCA and CPB. There was massive intraoperative bleeding, and patient
died on the fourth day due to sepsis and ARDS.