Bentall手術後遠隔期の仮性瘤に対して再手術を施行した1例

Reoperation for Pseudoaneurysm Late After Bentall Procedure：Report of a Case

はじめに　Bentall手術は大動脈基部置換術の標準術式の一つである．われわれはBentall手術後の遠隔期に発生した基部縫合線仮性瘤に対する再手術例を経験したので，若干の文献的考察を加えて報告する．

We report a case of reoperation for pseudoaneurysm late after Bentall procedure. A 61-year-old man who had undergone Bentall procedure eight years previously was found to have fluid collection around the graft on routine computed tomography （CT） follow-up. Contrast-enhanced CT revealed extravasation of contrast medium, and he was diagnosed with a pseudoaneurysm of the aorta. During surgery, extracorporeal circulation was temporarily stopped prior to resternotomy to avoid massive hemorrhage. The pseudoaneurysm was due to dehiscence of 4/5 circumference of the proximal suture line. The previous composite graft was removed and replaced with a new graft. The patient recovered well and was discharged on postoperative day 12. This case illustrates the importance of regular imaging surveillance after aortic root replacement and careful surgical planning for reoperations to prevent catastrophic bleeding complications.