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JPY
Abstract
Aortopulmonary fistula is an extremely rare complication of aortic dissection. We report acase of a chronic dissecting giant aneurysm with an aortopulmonary fistula. A 78-year-oldwoman experienced sudden onset chest pain and oppression. Chest X-ray showed ascendingaortic and left ventricular enlargement and pulmonary congestion. Computed tomography(CT)confirmed the 100mm ascending aortic aneurysm with dissection and aortopulmonary fistula.Operative repair was performed under profound hypothermic circulatory arrest with selectivecerebral perfusion. The proximal and distal end were obliterated using a gelatin-resorcinformaldehydetissue glue and reinforced with a Teflon felt circumferential strip.The ascendingaorta was replaced by a 30mm coated Dacron vascular graft and the aortopulmonary fistula wasclosed with pledgeted vertical mattress suture. Postoperative CT showed a normally functioningvascular implant without any sign of aortopulmonary shunt or pulmonary artery stenosis
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