P283. Repair of Aortic Root Pseudoaneurysm
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
St. Joseph Medical Center
Syracuse, NY
United States - Contact Me
Dr Charles Lutz is an adult cardiac surgeon at the St. Joseph’s Hospital Health System in Syracuse, New York and has been in practice since 2002. He performs a high volume of robotic and minimally invasive valve and coronary bypass surgery and is a mitral valve repair reference surgeon at St. Joseph’s Hospital. The St. Joseph’s Hospital cardiac surgery program has a long history of clinical excellence and recently received a 3 star rating in all 5 STS index procedure categories.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: Repair of aortic root pseudo aneurysms can be challenging and necessitates careful surgical planning.
Case Video Summary: A 72 year old female patient underwent ascending aorta replacement with a hemashield graft 37 years ago and was found to have an incidentally discovered 6.5cm pseudo aneurysm likely arising from the proximal anastomosis and adherent to the undersurface of the sternum. The case illustrates the need to be on cardiopulmonary bypass with moderate hypothermia prior to performing the
sternotomy. The intraoperative TEE showed severe mitral regurgitation with a large P2/P3 cleft that necessitated adding a mitral valve repair procedure. The distal aorta was relatively normal and able to be cross-clamped. The cardioplegia strategy involved selective coronary antegrade delNido cardioplegia given after opening the pseudo aneurysm. There was a partial dehiscence of the proximal suture line and the entire aortic root was calcified which necessitated a full aortic root replacement with a porcine stentless aortic valve. The video shows the details of that procedure. The previous hemashield graft was intact and left in place to simplify the procedure and avoid deep hypothermic circulatory arrest.
Conclusions: Careful surgical planning and execution allows for safe completion of a complex repair of an aortic root pseudo aneurysm.
Authors
Charles Lutz (1), Mark Lutz (2), Ahmad Nazem (3), Gary Green (4), Anton Cherney (5), Krishna Patel (5), Karikehalli Dilip (6), Zhandong Zhou (7)
Institutions
(1) N/A, Syracuse, NY, (2) N/A, United States, (3) St. Joseph's Hospital, Syracuse, NY, (4) St Joseph's Health, Syracuse, NY, (5) N/A, N/A, (6) St Joseph's Hospital, Syracuse, NY, (7) N/A, NY
Case Video Summary: A 72 year old female patient underwent ascending aorta replacement with a hemashield graft 37 years ago and was found to have an incidentally discovered 6.5cm pseudo aneurysm likely arising from the proximal anastomosis and adherent to the undersurface of the sternum. The case illustrates the need to be on cardiopulmonary bypass with moderate hypothermia prior to performing the
sternotomy. The intraoperative TEE showed severe mitral regurgitation with a large P2/P3 cleft that necessitated adding a mitral valve repair procedure. The distal aorta was relatively normal and able to be cross-clamped. The cardioplegia strategy involved selective coronary antegrade delNido cardioplegia given after opening the pseudo aneurysm. There was a partial dehiscence of the proximal suture line and the entire aortic root was calcified which necessitated a full aortic root replacement with a porcine stentless aortic valve. The video shows the details of that procedure. The previous hemashield graft was intact and left in place to simplify the procedure and avoid deep hypothermic circulatory arrest.
Conclusions: Careful surgical planning and execution allows for safe completion of a complex repair of an aortic root pseudo aneurysm.
Authors
Charles Lutz (1), Mark Lutz (2), Ahmad Nazem (3), Gary Green (4), Anton Cherney (5), Krishna Patel (5), Karikehalli Dilip (6), Zhandong Zhou (7)
Institutions
(1) N/A, Syracuse, NY, (2) N/A, United States, (3) St. Joseph's Hospital, Syracuse, NY, (4) St Joseph's Health, Syracuse, NY, (5) N/A, N/A, (6) St Joseph's Hospital, Syracuse, NY, (7) N/A, NY
Presentation Duration
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