Thoracoabdominal aortic aneurysm associated with umbilical artery catheterization: Case report and review of the literature Chris Cribari, MD, Frederick.

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Presentation transcript:

Thoracoabdominal aortic aneurysm associated with umbilical artery catheterization: Case report and review of the literature Chris Cribari, MD, Frederick A. Meadors, MD, E.Stanley Crawford, MD, Joseph S. Coselli, MD, Hazim J. Safi, MD, Lars G. Svensson, MD, PhD Journal of Vascular Surgery Volume 16, Issue 1, Pages 75-86 (July 1992) DOI: 10.1016/0741-5214(92)90421-4 Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Drawing demonstrates insertion site and position of umbilical artery catheter in descending thoracic aorta. Stippling indicates site of infection. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Radiographic illustration of thoracoabdominal aneurysm presenting as posterior mediastinal mass. A, CT scan of lower thoracic aorta. Arrows indicate aneurysm margin. B, Plain chest radiograph. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 A, CT scan of abdomen shows size and extent of abdominal portion of aneurysm. B, Drawing and transseptal aortogram demonstrates complete extent of aneuryms. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Serial drawings illustrate technique of operation used to obtain maximum amount of autogenous tissue possible. A, Demonstration of oblique right lateral decubitus positioning for thoracoabdominal exploration and lateral approach to aneurysm. B, Balloon-tipped Foley catheter positioned in descending thoracic aorta to calibrate desired aortic lumen size after imbrication of aortic wall, preserve intercostal arteries, and control back bleeding. C, Reconstruction of new iliac artery bifurcation. D, Suture technique reattaches new iliac artery, bifurcation to 8 mm albuminized knitted Dacron infrarenal tube graft. E, Placement of a second row of continuous polypropylene imbricating sutures. F, Drawing demonstrates operative site after resection of redundant wall of aneurysm. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Drawing and aortogram of completion transseptal aortogram performed on postoperative day 14. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Drawings and aortograms of late follow-up transseptal aortogram performed 15 months after operation in comparison with aortogram from postoperative day 14. Journal of Vascular Surgery 1992 16, 75-86DOI: (10.1016/0741-5214(92)90421-4) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions