Ferreira-Piña B, Ramírez-Castañeda S, Prado-Villegas G, Careaga-Reyna G, Argüero-Sánchez R

Language: Spanish
References: 27
Page: 57-60
PDF size: 113.46 Kb.

ABSTRACT

Innominate artery aneurysms are an uncommon pathology. There are several pathogenic mechanisms involved in their formation, and patients are usually asymptomatic. However, different clinical presentations are possible. Management varies according to anatomic characteristics. Surgical treatment is recommended in order to avoid complications. We present a case of a patient with an innominate artery anerysm found incidentally during surgery for myocardial revascularization. A 77-year-old male with unstable angina secondary to multivascular ischemic heart disease was subjected to surgery. Coronary angiography did not evaluate the aortic arch and its branches. During the surgical procedure we found a 2-cm saccular aneurysm at the origin of the innominate artery. After completing the revascularization procedure and once the patient was no longer on cardiopulmonary bypass, aneurysmorraphy was successfully done.

REFERENCES

1. Zarins CK, Heikkinen MA, Hill BB. Aneurysmal vascular disease. In: Townsend CM, ed. Sabiston Textbook of Surgery. 17th ed. Philadelphia. W.B. Saunders; 2005. pp. 1265-1314.

2. 2.Kieffer E, Chiche L, Koskas F, Bahnini A. Aneurysms of the innominate artery: surgical treatment of 27 patients. J Vasc Surg 2001;34:222-228.

3. Ninomiya H, Kuwabara M, Hayase T, Furukawa K, Onitsuka T. Mycotic pseudoaneurysm of the brachiocephalic artery. Jpn J Thorac Cardiovasc Surg 2004;52:155-157.

4. Biebl M, Neuhauser B, Perkmann R, Tauscher T, Ealdenberger P, Fraedrich G. Traumatic pseudoaneurysm of the brachiocephalic artery following mediastinoscopy: initial endovascular repair followed by open surgerya case report. Am Surg 2003;69:542-545.

5. Regina G, Fullone M, Testini M, Todisco C, Greco L, Rizzi R, et al. Aneurysms of the supra-aortic trunks in Takayasu’s disease: report of two cases. J Cardiovasc Surg 1998;39:757-760.

6. García-Porrúa C, Pego-Reigosa R, Piñeiro A, Armesto V, González-Gay MA. Supraclavicular pulsatile mass as presenting sign of brachiocephalic trunk aneurysm in the long-term followup of giant cell arteritis. Arthritis Rheum 2005;53:475-476.

7. Matsumara K, Hirano T, Takeda K, Matsuda A, Nakagawa T, Yamaguchi N, et al. Incidence of aneurysms in Takayasu’s arteritis. Angiology 1991;42:308-315.

8. Akio I, Yukio C, Tetsuya K, Moichi M, Takahiko U, Ryusuke M. Iatrogenic false aneurysm of the brachiocephalic artery: a complication of total parenteral nutrition. J Trauma 1999;47:975-977.

9. Regina G, Greco L, Testini M, Todisco C, Iusco D, Rizzi R. Treatment of supra-aortic trunk aneurysms: report on 16 cases. Chir Ital 1999;51:139-144.

10. Kurihara H, Tsuchiya K, Ohsawa H, Saito H, Iida Y, Noda Y, et al. Coronary revascularization in a patient with bilateral internal carotid artery stenosis and aneurysm of the brachiocephalic artery: a case report. Kyobu Geka 2000;53:225-228.

11. 11.Hideaki M, Yoshitaka O, Yoshihiko M, Hiroshi I, Yasuyuki Y, Kunihiro E, et al. A surgical case of concomitant aneurysms of the brachiocephalic and coronary arteries. Ann Thorac Cardiovasc Surg 2005;11:128-131.

12. Chambers CM, Curci JA. Treatment of nonaortic aneurysms in the endograft era: aneurysms of the innominate and subclavian arteries. Semin Vasc Surg 2005;18:184-190.

13. Saito A, Shiono M, Yamamoto T, Inoue T, Hata M, Sezai A, et al. Surgical treatment for innominate artery aneurysm with a coronary pulmonary artery fistula: a case report. Ann Thorac Cardiovasc Surg 2005;11:55-58.

14. Brewster DC, Moncure AC, Darling RC, Ambrosino JJ, Abbott WM. Innominate artery lesions: problems encountered and lessons learned. J Vasc Surg 1985;2:99-112.

15. Melissano G, Civilini E, Marrocco-Trischitta MM, Chiesa R. Hybrid endovascular and off-pump open surgical treatment for synchronous aneurysms of the aortic arch, brachiocephalic trunk and abdominal aorta. Tex Heart Inst J 2004;31:283-287.

16. Guibaud J-P, Laborde MN, Dubrez J. Surgical repair of an aneurysm of the innominate artery with fistulization into the trachea. Ann Vasc Surg 2001;15:412-414.

17. Sader AA, Cherri J, Ceneviva R. Massive tracheal necrosis due to compression by an innominate artery aneurysm associated with a grade IV chagasic megaesophagus and chronic duodenal ulcer. Chest 1999;116:837-840.

18. McFarland JJ, Kahn MB, Bellows CF, Shah RM, Koeningsberg RA, et al. Superior vena cava syndrome caused by aneurysm of the innominate artery. Ann Thorac Surg 1995;59:227-229.

19. Butman S, Gardin JM, Knoll M. Innominate artery aneurysm with thrombus: detection by two-dimensional echocardiography. J Am Coll Cardiol 1983;2:387-390.

20. Bush RL, Hurt JE, Bianco CC. Endovascular management of a ruptured mycotic aneurysm of the innominate artery. Ann Thorac Surg 2002;74:184-186.

21. Hirose H, Moore E. Delayed presentation and rupture of a posttraumatic innominate artery aneurysm: case report and review of the literature. J Trauma 1997;42:1187-1195.

22. 22.Takaba K, Aota M, Koike H, Konishi Y. Surgical treatment for intrathoracic aneurysm of the innominate artery in an 83-year-old asymptomatic woman. Jpn J Thorac Cardiovasc Surg 2004;52:194-197.

23. Bower TC, Pairolero PC, Hallett JW Jr, Toomey BJ, Gloviczki P, Cherry KJ Jr. Brachiocephalic aneurysm: the case for early recognition and repair. Ann Vasc Surg 1991;5:125-132.

24. Adkins MS, Gaines WE, Laub GW, Anderson WA, Fernandez J, McGrath LB. Management of an innominate artery aneurysm during an open heart operation. Ann Thorac Surg 1993;56:377-379.

25. Puech-Leao P, Orra HA. Endovascular repair of an innominate artery true aneurysm. J Endovasc Ther 2001;8:429-432.

26. Marone EM, Esposito G, Kahlberg A. Surgical treatment of tracheoinnominate fistula after stent-graft implantation. J Thorac Cardiovasc Surg 2007;133:1641- 1643.

27. Pruitt A, Dodson TF, Najibi S, Thourani V, Sherman A, Cloft H, et al. Distal septic emboli and fatal brachiocephalic artery mycotic pseudoaneurysm as a complication of stenting. J Vasc Surg 2002;36:625-628.