Urgent Frozen Elephant Trunk for an Aortic Arch Pseudoaneurysm Secondary
to Fractured Sternal Wire
Pseudoaneurysms of the aorta are rare complications of cardiac surgery,
and sternal re-entry to address the pathology is particularly
challenging. In this case, we describe a rare presentation of thoracic
aortic pseudoaneurysm due to chronic erosion from a sternal wire, 10
years following the index operation. The patient was treated in
two-stages, including carotid-subclavian bypass, followed by sternal
re-entry with total arch replacement and frozen elephant trunk,
employing cardiopulmonary bypass via femoral and axillary cannulation.
Despite the high risks of rupture/haemorrhage associated with sternal
re-entry, operative success for aortic pseudoaneurysms can be achieved
with careful planning and safe bypass strategies.