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Abstract
Un patient de 64 ans, hypertendu, a été admis pour un anévrisme de l'aorte ascendante de 82,7 mm et une insuffisance aortique modérée. L'échocardiographie et le scanner thoracique ont révélé un anévrisme de 82,7 mm et un arc aortique bovin. Après évaluation, une intervention de Bentall a été réalisée sans complication liée à l'arc bovin. Après une anémie postopératoire corrigée par transfusion, l’évolution clinique a été favorable avec un bon fonctionnement de la bioprothèse aortique. Ce cas souligne l'importance d'une évaluation clinique et radiologique approfondie pour une planification optimale et des résultats satisfaisants dans les cas complexes d'anévrismes aortiques.
ABSTRACT
A 64-year-old hypertensive patient was admitted for an 82.7 mm ascending aortic aneurysm and moderate aortic insufficiency. Echocardiography and chest CT revealed an 82.7 mm aneurysm and a bovine aortic arch. After evaluation, a Bentall procedure was performed without complications related to the bovine arch. Postoperative anemia was corrected with a transfusion, and the clinical outcome was favorable, with proper functioning of the aortic bioprosthesis. This case highlights the importance of thorough clinical and radiological evaluation for optimal planning and satisfactory outcomes in complex aortic aneurysm cases.
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References
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- Marrocco-Trischitta MM, Alaidroos M, Romarowski RM, Milani V, Ambrogi F, Secchi F, et al. Aortic arch variant with a common origin of the innominate and left carotid artery as a determinant of thoracic aortic disease: a systematic review and meta-analysis. European Journal of Cardio-Thoracic Surgery. 2019 Oct 16;
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- Lippert H, Pabst R. Arterial variations in man: classification and frequency. 1985. 3–10 p.
- De Garis CF, Black IH, Riemenschneider EA. Patterns of the Aortic Arch in American White and Negro Stocks, with Comparative Notes on Certain Other Mammals. J Anat. 1933 Jul;67(Pt 4):599–619.
- Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968 Jul 1;23(4):338–9.
- Nardi P, Pisano C, Bassano C, Bertoldo F, Salvati AC, Buioni D, et al. Bentall Operation: Early Surgical Results, Seven-Year Outcomes, and Risk Factors Analysis. Int J Environ Res Public Health. 2022 Dec 23;20(1):212.
- Kalra SK, Thilagar B, Khambaty M, Manjarrez E. Post-operative Anemia After Major Surgery: a Brief Review. Curr Emerg Hosp Med Rep. 2021 Sep 16;9(3):89–95.
- Botea R, Lavie-Badie Y, Goicea A, Porterie J, Marcheix B. Early and midterm outcomes of a bentall operation using an all-biological valved BioConduitTM. J Cardiothorac Surg. 2022 Dec 19;17(1):325.
References
Erbel R, Aboyans V, Boileau C, Bossone E, Di Bartolomeo R, Eggebrecht H, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J [Internet]. 2014 Nov 1 [cited 2024 Dec 7];35(41):2873–926. Available from: https://pubmed.ncbi.nlm.nih.gov/25173340/
Malone CD, Urbania TH, Crook SES, Hope MD. Bovine aortic arch: A novel association with thoracic aortic dilation. Clin Radiol. 2012 Jan;67(1):28–31.
Yousef S, Singh S, Alkukhun A, Alturkmani B, Mori M, Chen J, et al. Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease. J Card Surg. 2021 Jul;36(7):2348–54.
Senser EM, Misra S, Henkin S. Thoracic Aortic Aneurysm. Cardiol Clin. 2021 Nov;39(4):505–15.
Marrocco-Trischitta MM, Alaidroos M, Romarowski RM, Milani V, Ambrogi F, Secchi F, et al. Aortic arch variant with a common origin of the innominate and left carotid artery as a determinant of thoracic aortic disease: a systematic review and meta-analysis. European Journal of Cardio-Thoracic Surgery. 2019 Oct 16;
Marrocco-Trischitta MM, Alaidroos M, Romarowski RM, Secchi F, Righini P, Glauber M, et al. Geometric Pattern of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant. European Journal of Vascular and Endovascular Surgery. 2020 May;59(5):808–16.
Lippert H, Pabst R. Arterial variations in man: classification and frequency. 1985. 3–10 p.
De Garis CF, Black IH, Riemenschneider EA. Patterns of the Aortic Arch in American White and Negro Stocks, with Comparative Notes on Certain Other Mammals. J Anat. 1933 Jul;67(Pt 4):599–619.
Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968 Jul 1;23(4):338–9.
Nardi P, Pisano C, Bassano C, Bertoldo F, Salvati AC, Buioni D, et al. Bentall Operation: Early Surgical Results, Seven-Year Outcomes, and Risk Factors Analysis. Int J Environ Res Public Health. 2022 Dec 23;20(1):212.
Kalra SK, Thilagar B, Khambaty M, Manjarrez E. Post-operative Anemia After Major Surgery: a Brief Review. Curr Emerg Hosp Med Rep. 2021 Sep 16;9(3):89–95.
Botea R, Lavie-Badie Y, Goicea A, Porterie J, Marcheix B. Early and midterm outcomes of a bentall operation using an all-biological valved BioConduitTM. J Cardiothorac Surg. 2022 Dec 19;17(1):325.