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Video 1 Three-dimensional reconstruction of thoracic and abdominal aorta
Opmerkingen
Video online
The online version of this article contains one video. The article and the video are online available (https://doi.org/10.1007/s12471-023-01767-2). The video can be found in the article back matter as “Electronic Supplementary Material”.
A 76-year-old female consulted her general practitioner because of new-onset leg oedema and dyspnoea. Medical records revealed a history of smoking and hypertension. The diagnosis of chronic obstructive pulmonary disease was considered, and a chest X‑ray was performed, which showed a broadened mediastinum. Computed tomography angiography revealed a supracoronary aorta aneurysm of 10.1 cm in diameter reaching to the brachiocephalic trunk (Fig. 1 and see Video 1 in Electronic Supplementary Material). The patient was accepted for urgent aortic surgery. After induction of anaesthesia and during preparations for cardiopulmonary bypass, multiple episodes of hypotension with desaturation occurred, which were treated with fluid administration. During hypothermic circulatory arrest with selective cerebral perfusion, the ascending aorta and arch were replaced.
Fig. 1
Computed tomography angiography of aorta, in a sagittal view and b transversal view. Arrows mark compression of both superior vena cava (SVC) and inferior vena cava (IVC)
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An isolated supracoronary aorta aneurysm larger than 10 cm is rare [1] and is mostly of unknown aetiology. In retrospect, this large aneurysm caused compression of the left atrium and the inferior and superior vena cava, compromising cardiac preload, mimicking cardiac tamponade and causing pulmonary congestion and chronic venous stasis, which explained the patient’s symptoms.
Conflict of interest
J.R. Olsthoorn and K.Y. Lam declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
