Document Detail

Vascular prosthesis rupture caused by contact with rib stump after thoracic aorta replacement.
MedLine Citation:
PMID:  19563969     Owner:  NLM     Status:  MEDLINE    
A 42-year-old male with Marfan syndrome, who had undergone aortic root and total arch replacement for type-A acute aortic dissection at the age of 40, underwent descending aorta replacement with woven Dacron (Vascutek Ltd., Renfrewshire, Scotland) because of pseudoaneurysm at the site of the distal anastomosis and an enlarged pseudolumen of the dissecting descending aorta. The fourth and eighth ribs were cut at their anterior and posterior sites to allow wide exposure of the entire descending aorta. Postoperative computed tomographic scanning showed that the vascular prosthesis posteriorly contacted the eighth rib stump. On the postoperative day 25, the patient collapsed and developed severe hypotension. Emergency thoracotomy revealed a 6 mm in diameter hole on the posterior side of the vascular prosthesis. One day later, the patient died of cardiac dysfunction resulting from sustained hypotension. Electron microscopic examination of the vascular prosthesis showed that the hole was caused by frayed fabric and disrupted polyester fibers. Our experience warns that a woven polyester vascular prosthesis could rupture within 3 weeks of contacting a rib stump.
Hiroshi Yamamoto; Fumio Yamamoto; Kazuyuki Ishibashi; Yasuharu Noishiki
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  50     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-30     Completed Date:  2009-07-09     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-7     Citation Subset:  IM    
Department of Cardiovascular Surgery, Akita University School of Medicine, Akita, Japan.
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MeSH Terms
Aneurysm, Dissecting / etiology,  surgery*
Aorta, Thoracic / surgery*
Aortic Aneurysm / etiology,  surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects*
Fatal Outcome
Marfan Syndrome / complications
Prosthesis Failure*
Ribs / surgery

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

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