A Giant Sternum-eroding Aneurysm of the Ascending Aorta and Aortic Arch

Abstract

Background: Giant aneurysms of the ascending aorta, defined as aneurysms of more than 10 cm in diameter, are a rare finding. They represent a high risk of dissection or rupture and can also compress the surrounding structures and organs. Generally, the only effective treatment is surgery. Case report: In this report we present a case of a giant sternum-eroding aneurysm of the ascending aorta and aortic arch in a progressively dyspnoic 34-year old female and describe a stepwise surgical approach as the optimal treatment. Conclusion: Surgical treatment of giant aneurysms of the ascending aorta carries high morbidity and mortality particularly when compressing the surrounding structures or causing bone erosion. A stepwise surgical approach with the establishment of CPB and hypothermia prior to sternotomy, precise surgical technique, and meticulous postoperative care are the factors which significantly improve the safety and efficacy of the procedure and all contribute to a better outcome.