Document Detail


Recurrent aortic aneurysms following thoracic aortic stent-graft repair in a patient with Cogan syndrome.
MedLine Citation:
PMID:  17154705     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the need for multiple surgical interventions to treat recurrent aortic aneurysms in a patient with Cogan syndrome. CASE REPORT: A 17-year-old Chinese man with clinical Marfanoid features had a left common carotid artery pseudoaneurysm electively repaired with an autologous saphenous vein graft. Four months later, he presented with acute chest pain. Computed tomography (CT) revealed a 1-cm pseudoaneurysm at the mid descending aorta; a 24 x 100-mm Talent stent-graft was implanted to exclude the pseudoaneurysm. He was also found to have increasing left-sided hearing loss. A month later, the patient was re-admitted with vertigo and keratitis, which were treated appropriately. Nine months following stent-graft insertion, he was admitted with acute hemoptysis. Urgent CT showed a rupture at the proximal end of the stent-graft, with hemorrhage into the lung parenchyma. In an emergent procedure, the stent-graft was removed, and the descending thoracic aorta was repaired. Intraoperatively, a large pseudoaneurysm was found arising from the proximal part of the stented aorta, which appeared thickened. His postoperative recovery was uneventful. Nine months after the thoracotomy, a routine CT revealed an aneurysm at the distal descending thoracic aorta. On re-thoracotomy, a de novo saccular aneurysm was found 2.5 cm from the distal anastomosis. The affected segment was replaced with a Dacron graft. The distal aorta appeared thickened and edematous; histology confirmed aortitis. The patient was subsequently diagnosed with Cogan syndrome and given corticosteroids and methotrexate. There is no evidence of recurrence at nearly 2 years after the last intervention. CONCLUSION: This case highlights the pitfalls of stent-graft repair in a patient with presumed connective tissue disease.
Authors:
Jang Wen Su; Andrea Hsiu Ling Low; Kiang Hiong Tay; Matthew G Sebastian; Julian Thumboo; Kenny Yoong Kong Sin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  13     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  779-82     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, National Heart Centre, 17 Third Hospital Avenue, Singapore 168752. bottle1001@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, False* / diagnosis,  etiology,  therapy
Angioplasty, Balloon / methods*
Aortic Aneurysm, Thoracic* / diagnosis,  etiology,  therapy
Aortitis / complications
Aortography
Blood Vessel Prosthesis Implantation / methods*
Hearing Disorders / complications
Heart Bypass, Left
Humans
Keratitis / complications
Magnetic Resonance Imaging
Male
Recurrence
Reoperation
Stents*
Syndrome
Thoracotomy
Tomography, X-Ray Computed
Vertigo
Vestibular Diseases / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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