Contained rupture of a pseudoaneurysm of the descending thoracic aorta related to remnant outflow graft of left ventricular assist device after heart transplantation.

Abstract

The Jarvik 2000 left ventricular assist device is inserted via a left thoracotomy with the outflow graft anastomosed to the descending thoracic aorta. Removal of the device during heart transplantation involves division of the outflow graft, resulting in a retained remnant. We describe the first reported case of a mycotic pseudoaneurysm of the descending thoracic aorta related to the remnant of a left ventricular assist device outflow graft in an immunosuppressed heart recipient complicated with systemic Pseudomonas infection. The pseudoaneurysm was temporarily treated with endovascular stent grafting followed by delayed thoracotomy, pseudoaneurysm excision, and placement of an aortic interposition graft using an aortic allograft.

• Authors: Kentaro Yamane, Linda J Bogar, Paul J DiMuzio, Scott W Cowan, Hitoshi Hirose, Nathaniel R Evans 3rd, Atul S Rao, Joshua A Eisenberg, Nicholas C Cavarocchi
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 94 Issue 4 Pg. 1345-8 (Oct 2012) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 23006696 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Aneurysm, False (diagnosis, etiology, surgery)
• Aneurysm, Ruptured (diagnosis, etiology, surgery)
• Aortic Aneurysm, Thoracic (diagnosis, etiology, surgery)
• Diagnosis, Differential
• Follow-Up Studies
• Heart Failure (surgery)
• Heart Transplantation (adverse effects, methods)
• Heart-Assist Devices (adverse effects)
• Humans
• Male
• Middle Aged
• Prosthesis Failure
• Tomography, X-Ray Computed
• Vascular Surgical Procedures (methods)
• Ventricular Outflow Obstruction (complications, diagnosis, surgery)