Abdominal aortic aneurysm with rupture into the inferior vena cava/Vena kava inferiyor'a rupture olan abdominal aort anevrizmas.A 65-year-old man referred to our institute with an emergent situation. Physical examination revealed sinus tachycardia (130 beats/min), hypotension (90/35 mmHg), large pulsatile pulsatile /pul·sa·tile/ (pul´sah-til) characterized by a rhythmic pulsation.
characterized by a rhythmic pulsation. mass in abdomen, hemoglobin: 10.1 gr/dl. We considered abdominal aneurysm rupture and performed computerized tomography scanning. It showed juxta-renal abdominal aortic aneurysm abdominal aortic aneurysm A focal aortic dilation of ≥ 50% ↑ in diameter, accompanied by distension and weakened aortic wall Epidemiology Incidence is rising 12/105–1951; 36/105 (AAA AAA: see American Automobile Association.
(Triple A) A common single-cell battery used in a myriad of electronic devices of all variety. Like its double A (AA) cousin, it provides 1.5 volts of DC power. When used in series, the voltage is multiplied. ) and long segment aorto-caval fistula fistula (fĭs`chlə), abnormal, usually ulcerous channellike formation between two internal organs or between an internal organ and the skin. (Fig. 1). The patient emergently was taken to operating room. Firstly, we opened abdomen and revealed big AAA (more than 10 cm), then we prepared aneurysm but we could not take it on cross-clamp inside abdomen. The incision was extended to thoracic level (9. cartilage) and we took on cross-clamp above diaphragm. When we opened aneurysm sac, suddenly and rapidly bleeding occurred,we controlled caval bleeding with balloon catheter and performed proximal aortic anastomosis anastomosis /anas·to·mo·sis/ (ah-nas?tah-mo´sis) pl. anastomo´ses [Gr.]
1. communication between vessels by collateral channels.
2. with 18/9 aorta-iliac graft on renal arteries (Jotec Inc. Minnesota, USA). We took off aortic cross clamp and repaired caval injury with 2x8 cm. Dacron patch. Aorto-caval fistula is very rare complication of AAA and this pathology can be repaired with endovascular graft replacement. In this case, caval injury was in a long segment and we had to use Dacron patch for inferior vena cava inferior vena cava
n. Abbr. IVC
A large vein formed by the union of the two common iliac veins that receives blood from the lower limbs and the pelvic and abdominal viscera and empties into the right atrium of the heart. . We used expandable balloon catheter for cessation of bleeding in this case. It was very useful and life saving procedure and we repaired tear of inferior vena cava without bleeding complications easily (Fig. 2).
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Mehmet Ates, Ufuk Ciloglu, Ahmet Umit Gullu, Sabri Dagsali, Ibrahim Yekeler
Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey
Address for Correspondence/Yazisma Adresi: Dr. Mehmet Ates Sairarsi Cad. Emincinarpasa Sok. No: 6/24 Kadikoy 34732, Istanbul, Turkey Phone: +90 216 360 02 72 E-mail: firstname.lastname@example.org