CTA features and clinical analysis 20 cases of cardiovascular postcperatiure aorta pseudoaneurysms

LIU Jia-wei; LIYu; ZHANG Nan; LUO Nan; WANG Wen-chuan; WEN Zhao-ying; LIU Dong-ting; FAN Zhan-ming

Abstract：Objective To discuss the CTA and clinical features of postoperative aortic pseudoaneurysm and to evaluate the diagnostic value of CTA .Methods We retrospectively analyzed the CTA images and clinical dates of postoperative pa‐tients with aortic pseudoaneurysm from March 2009 to December 2013 undergoing cardiovascular surgery .We identified 20 patients(17 male ,3 females respectively) ,with mean age (50 .3 ± 7 .9) years (range 21~70 years) .All of them had his‐tories of cardiovascular surgeries ,including 8 cases of thoracic endovascular aortic repair TAVAR (including 2 cases of chimney surgery ) ,7 cases of aorta replacement (2 cases of ascending aorta replacement ,1 case of ascending aorta and com‐plete archreplacement ,2 cases of ascending aorta and aortic arch replacement +descending aorta stent implantation ,2 ca‐ses of descending aorta replacement ) ,1 case of ventricular septal defect and patent ductus arteriosus repair ,1 case of con‐genital aortic aneurysm repair ,2 cases of the combined mitral and aortic valve replacement ,1 case of pericardiocentesis . Results We found 6 cases of the pseudoaneurysm located in the ascending aorta ,4 cases in the aortic arch ,9 cases in the descending aorta and 1 case in the abdominal aorta .In all cases ,the pseudoaneurysm was solitary and lopsided ,locating outside the outline of aorta ,with anomalous formation and thick aneurismal wall .Themean tumor size was (48 .5 ± 9 .3) cm2 (range 10 .8~98 cm2 ) .It can be seen that holes communicated with lumens in all cases .The mean diameter of holes was (12 .3 ± 4 .2) mm (range 5 .0~24 .0 mm) .18 patients underwent the second operations .The sizes of pseudoaneurysm and holes measured by CTA were not significantly different from those of found during operations .18 patients were fol‐lowed up ,with the mean follow‐up period of 146 days and the follow‐up rate of 90% .The mortality during follow‐up was 10% .Conclusion The cardiovascular surgery is a common cause of the formation of aortic pseudoaneurysm ,which has a high risk of rupture and death .It should be cured immediately once observed .Meanwhile ,the regular check is also essen‐tial for patients after cardiovascular surgery .Aortic CTA images can show the sign of pseudoaneurysm specially andaccu‐rately ,and are suitable for the preoperative diagnosis and postoperative follow‐up .