Aortic Root and Ascending Aortic Aneurysm Related to One Case. Reimplantation of the Right Coronary Artery by 8 mm Dacron Tube (Cabrol Hemi Mustache) and Review of the Literature

Abdoulaye Kanté,Bréhima Bengaly,Bréhima Coulibaly,Drissa Traoré,Samba Sidibé,Mariam Daou,Demba Yattera,Nouhoum Ongoïba,Mamadou Diakité

doi:10.4236/ojts.2021.111001

Abstract

The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron&#174 tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.

Highlights

The aortic aneurysm is the 13th leading cause of death in Western countries [1]
The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000
When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture

Summary

Introduction

The aortic aneurysm is the 13th leading cause of death in Western countries [1]. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000 [1] [2]. Patients are younger (30 - 50 years), with a sex ratio of 1:1. Chronic dissections of the ascending aorta usually develop with an associated aneurysm [1] [3]. Aneurysm formation following bacterial infection of the lining of the ascending aorta is rare. Arteritis is even rarer; Takayashu’s disease usually produces obstructive lesions, but can present with aortic aneurysms in 15% of cases [1]. The incidence of dissection or rupture of the aneurysm increases with its size [6]. The critical size of the dilated ascending aorta from which the risk of rupture or dissection becomes greater than the risk of elective surgery is decisive for the management of this disease. We report a case of aneurysm of the aortic root and the ascending aorta and we review the literature

Clinical Observation

Discussion

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Conclusion