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Airway obstruction by an aortic false aneurysm.
MedLine Citation:
PMID:  22036790     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aortic false aneurysms are rare complications of aortic valve replacement and cardiac surgical procedures in general. Aortic false aneurysms can also presents as a mediastinal mass. A false aneurysm etiology should always be considered in mediastinal mass exploration of patients with a cardiac surgery history. Although, a computed tomography (CT) scan can detect a mediastinal mass, it can equally misdiagnose an aneurysm in the absence of tumour contrast enhancement. We present the case of a 60-year-old woman who was hospitalized for a laryngeal dyspnea. She had undergone aortic valve replacement 3 years earlier and had no other relevant medical history. In the last 3 months, she presented a progressively worsening dyspnea and cough. A chest radiograph showed a large mass in the superior mediastinum. A contrast-enhanced CT-scan showed an anterior mediastinal mass (9cm×8cm×9cm) not enhanced by contrast product, suggestive of a tissue density tumour. The mass was in fact an aortic false aneurysm where the communication with the aorta was too narrow to be filled by the contrast product in arterial phase imaging. The aneurysm was excised and successfully replaced with a prosthetic graft during deep hypothermic and circulatory arrest. In this case report, we discuss the unusual clinical presentation of this pseudoaneurysm and the absence of contrast enhancement during CT-scan, which could have lead to a catastrophic error.
Authors:
S Taillandier; A Guillon; O Favelle; D Garot; D Perrotin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-28
Journal Detail:
Title:  Annales francaises d'anesthesie et de reanimation     Volume:  -     ISSN:  1769-6623     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8213275     Medline TA:  Ann Fr Anesth Reanim     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Affiliation:
Service de réanimation médicale, université F.-Rabelais Tours, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
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