Right heart failure caused by direct pressure of distal arch aneurysm

We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2019-02, Vol.67 (2), p.263-265
Main Authors: Sugiyama, Hironobu, Tohma, Ryo, Misato, Takuya, Okamoto, Kazuma, Hayashi, Taro, Tobe, Satoshi, Matsuo, Tatsuro, Tsunemi, Kotaro, Oka, Takanori, Tanimura, Nobuhiro
Format: Article
Language:English
Subjects:
Aortic aneurysms
Aortic dissection
Cardiac Surgery
Cardiology
Case Report
Coronary vessels
Fistula
Heart failure
Medicine
Medicine & Public Health
Pulmonary arteries
Surgical Oncology
Syphilis
Thoracic Surgery
Veins & arteries
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Summary:We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension. Left ventricular function, however, was preserved. We diagnosed right heart failure caused by giant aortic arch aneurysm and performed emergency aortic arch aneurysm replacement. After the operation, pulmonary artery pressure decreased and right heart failure improved.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-018-0900-7