A Redo Case of a Non-Anastomotic False Aneurysm in a Shielded Knitted Dacron Graft 9 Years after the Primary Operation

DOI
  • Dohi Masahiro
    Department of Cardiovascular and Thoracic Surgery, Kusatsu General Hospital
  • Sirakata Shuji
    Department of Vascular Surgery, Kyoto Kuramaguchi Medical Center
  • Okumura Satoru
    Department of Cardiovascular and Thoracic Surgery, Kusatsu General Hospital

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  • Y 型人工血管置換術後9 年で分岐部に発症したシールドグラフト破綻による非吻合部瘤の1 例

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Description

A 68-year-old man with a pulsatile mass in his abdomen was admitted to our institution in 2013. He had undergone bifurcated graft reconstruction using a bifurcated Hemashield knitted Dacron graft for an abdominal aortic aneurysm 9 years prior, in 2004. Magnetic resonance imaging in 2010 showed a 44-mm mass around the body of the graft at a non-anastomotic site. The mass gradually expanded, similar to a pseudoaneurysm (56 mm in diameter in 2012, 69 mm in diameter in 2013), until extravasation of contrast media at the graft bifurcation was detected. This was diagnosed as a pseudoaneurysm due to graft disruption. Graft replacement was performed to prevent rupture of this pseudoaneurysm. During reoperation, the expanded preserved wall of the aneurysm, which was wrapped around the graft at the primary operation, and blood leakage at the bifurcation of the Dacron graft was found. We report a rare case of early disrupted bifurcation of a shielded Dacron graft that was implanted in 2000s, less than 10 years after the primary operation.

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