Surgical treatment of the ascending aorta aneurysm: simultaneous echocardiographic observation of coronary ostia reimplanted to vascular prosthesis

Aorta; aneurisma; cirurgia; ecocardiografia

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Surgical treatment of the ascending aorta aneurysm. Simultaneous echocardiographic observation of coronary ostia reimplanted to vascular prosthesis

Marcelo Luiz Campos Vieira; Anderson Benício; Wilson Mathias Jr.; Noedir A. Stolf

Instituto do Coração do Hospital das Clínicas – FMUSP - São Paulo, SP - Brazil

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Key words: Aorta, aneurysm, surgery, echocardiophy.

A 52-year-old man was admitted for surgical treatment of the ascending aorta aneurysm and aortic valve regurgitation. Upon presentation, he was found to have third heart sound (S3), 6/6+ diastolic murmur at the aortic area, and blood pressure of 3160 x 50 mm Hg. Multiplane transesophageal echocardiography (TEE) showed aneurysm of the ascending aorta measuring 7.3 cm (Figure 1), left ventricular diastolic diameter of 8.3 cm, left ventricular ejection fraction of 0.40 (Simpson's method), and severe aortic valve regurgitation. Echocardiographic findings were confirmed by chest tomography

The patient underwent a Dacron (Figure 2) aortic prosthesis implantation and aortic valve replacement using a Saint-Jude mechanical prosthesis Nº 27. Coronary ostia were reimplanted to the vascular prosthesis (Figure 3). Right coronary ostium was reimplanted above its anatomic position. Both reimplanted coronary ostia were simultaneously shown during intraoperative transesophageal echocardiogram. Blood flow at the left main coronary artery reimplanted to the vascular prosthesis is shown in figures 4 and 5. The patient evolved uneventfully in the postoperative period and was discharged ten days after surgical correction.

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Received on 7/18/05

Accepted on 7/25/05

Publication Dates

• Publication in this collection
  21 Nov 2006
• Date of issue
  Oct 2006

History

• Accepted
  25 July 2005
• Received
  18 July 2005