Giant Ascending Aortic Aneurysm Presented with Acute Onset Superior Vena Cava Syndrome

Jorge Alcocer

doi:10.19080/jocct.2019.14.555891

Abstract

Giant Ascending Aortic Aneurysm Presented with Acute Onset Superior Vena Cava Syndrome

Highlights

The ascending aorta is the second most common localization of degenerative aortic aneurysms after infrarenal abdominal aorta
We report a patient with previous aortic valve replacement surgery and a giant ascending aortic aneurysm complicated with aorta to superior vena cava fistula
This is a very rare complication that has been previously described in association with syphilitic aortitis [2,3], acute aortic dissection [4] and aortic pseudoaneurysms [5] but infrequently associated to degenerative ascending aortic aneurysms

Summary

Introduction

The ascending aorta is the second most common localization of degenerative aortic aneurysms after infrarenal abdominal aorta. We report a patient with previous aortic valve replacement surgery and a giant ascending aortic aneurysm complicated with aorta to superior vena cava fistula. This is a very rare complication that has been previously described in association with syphilitic aortitis [2,3], acute aortic dissection [4] and aortic pseudoaneurysms [5] but infrequently associated to degenerative ascending aortic aneurysms. A CT aortic angiogram revealed a 14,7 x 13cm giant ascending aortic aneurysm (Figure 1, panel A) with a type A aortic dissection compressing the superior vena cava and right atrium.

Discussion

Conclusion