https://doi.org/10.4081/monaldi.2024.2936
Asymptomatic giant ascending aortic aneurysm: a challenging surgical strategy for a silent bicuspid aortopathy
Submitted: January 29, 2024
Accepted: March 12, 2024
Published: March 18, 2024
Accepted: March 12, 2024
Abstract Views: 359
PDF_EARLY VIEW: 157
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
We report the case of an incidental finding of a huge aneurysm of the ascending aorta with a congenital bicuspid aortic valve type 0-lateral. This severe condition was totally unknown to the patient, who was asymptomatic for cardiovascular disease. The aneurysmal mass involved the entire mediastinum, altering the normal anatomical relations, so the operative strategy was modified intraoperatively, tailoring the surgical technique to the anatomical conditions found. Despite a delayed awakening, the patient had an uncomplicated postoperative course. Therefore, this case highlights the importance of not underestimating nonspecific, seemingly harmless symptoms and signs that may reveal potentially catastrophic pathologies, while also focusing on the surgical technique used. The modified Cabrol procedure, while an underutilized technique, if present in the cardiac surgeon's "arsenal," can represent a life-saving strategy in complex cases requiring an aortic valve and ascending aorta replacement.
Shah P, Gupta N, Goldfarb I, Shamoon F. Giant dissecting aortic aneurysm in an asymptomatic young male. Case Rep Vasc Med 2015;2015:958464.
DOI: https://doi.org/10.1155/2015/958464
Yamashita T, Hayashi T, Tabata T, at all. Bicuspid aortic valve-associated aortic dilatation - what is the mechanism of bicuspid aortopathy?. Circ J 25;82:2470-1.
DOI: https://doi.org/10.1253/circj.CJ-18-0844
Michelena HI, Della Corte A, Evangelista A, et al. International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes. J Thorac Cardiovasc Surg 2021;162:e383-e414.
DOI: https://doi.org/10.1016/j.jtcvs.2021.06.019
Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association/American College of Cardiology Joint Committee on clinical practice guidelines. Circulation 2022;146:e334-e482.
DOI: https://doi.org/10.1161/CIR.0000000000001097
Di Michele S, Parato VM, Di Giannuario G, et al. Unlocking insights in bicuspid aortic valve management in adult patients: the vital role of cardiac imaging. Monaldi Arch Chest Dis 2023;94(1).
DOI: https://doi.org/10.4081/monaldi.2023.2761
Okura T, Kitami Y, Takata Y, et al. Giant unruptured aneurysm of the thoracic aorta-a case report. Angiology 1999;50:865-9.
DOI: https://doi.org/10.1177/000331979905001012
Pape LA, Tsai TT, Isselbacher EM, et al. Aortic diameter >or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2007;116:1120-7.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.107.702720
Mossuto E, Milano A, Bortolotti U. The Cabrol technique for replacement of the aortic valve and totally calcified ascending aorta: a case report. J Heart Valve Dis 1994;3:98-100.
Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg 2007;133:1226-33.
DOI: https://doi.org/10.1016/j.jtcvs.2007.01.039
How to Cite
Romeo, Maria Grazia, Emanuele Pilato, Raffaele Giordano, Giuseppe Comentale, Gabriele Iannelli, Domenico Romeo, Bruna Miserrafiti, and Luigi Di Tommaso. 2024. “Asymptomatic Giant Ascending Aortic Aneurysm: A Challenging Surgical Strategy for a Silent Bicuspid Aortopathy”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2024.2936.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Sotirios D. Moraitis, Apostolos C. Agrafiotis, Dimitrios Pappas, Chrysovalantis Pothitakis, Maria Stergianni, Ioannis Koukis, Thymic pathology and cardiac myxomas: Coincidence or a closer relationship? , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- Rodolfo Citro, Antonello Panza, Paolo Masiello, Amelia Ravera, Lucia Tedesco, Rocco Leone, Marco Mirra, Roberta Giudice, Severino Iesu, Francesco Silvestri, Giuseppe Di Benedetto, Eduardo Bossone, Intramural aortic hematoma: no flap no warning? , Monaldi Archives for Chest Disease: Vol. 76 No. 1 (2011): Cardiac series
- Concezione Tommasino, Cardiovascular risk assessment in the senior population undergoing anesthesia for non-cardiac surgery , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Francesca Gatta, Yama Haqzad, George Gradinariu, Pietro Giorgio Malvindi, Zubair Khalid, Rona L. Suelo-Calanao, Nader Moawad, Aladdin Bashir, Luke J. Rogers, Clinton Lloyd, Bao Nguyen, Karen Booth, Lu Wang, Nawwar Al-Attar, Neil McDowall, Stuart Watkins, Rana Sayeed, Saleh Baghdadi, Andrea D’Alessio, Maria Monteagudo-vela, Jasmina Djordjevic, Matej Goricar, Solveig Hoppe, Charlotte Bocking, Azar Hussain, Betsy Evans, Salman Arif, Christopher Malkin, Mark Field, Kully Sandhu, Amer Harky, Ahmed Torky, Mauin Uddin, Muhammad Abdulhakeem, Ayman Kenawy, John Massey, Neil Cartwright, Nathan Tyson, Niki Nicou, Kamran Baig, Mark Jones, Firas Aljanadi, Colum G. Owens, Tunde Oyebanji, Joseph Doyle, Mark S. Spence, Paul F. Brennan, Ganesh Manoharan, Taha Ramadan, Sunil Ohri, Mahmoud Loubani, Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Roberto F.E. Pedretti, Francesco Fattirolli, Raffaele Griffo, Marco Ambrosetti, Elisabetta Angelino, Silvia Brazzo, Ugo Corrà , Nicolò Dasseni, Pompilio Faggiano, Giuseppe Favretto, Oreste Febo, Marina Ferrari, Francesco Giallauria, Cesare Greco, Manuela Iannucci, Maria Teresa La Rovere, Mario Mallardo, Antonio Mazza, Massimo Piepoli, Carmine Riccio, Simonetta Scalvini, Luigi Tavazzi, Pier Luigi Temporelli, Gian Francesco Mureddu, Cardiac Prevention and Rehabilitation “3.0â€: From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Samuele Baldasseroni, Francesco Orso, Alessandra Pratesi, Alice Foschini, Andrea Giosafat Marella, Nadia Bartoli, Ilaria Bracali, Alessando Antenore, Francesca Tarantini, Costanza Burgisser, Niccolò Marchionni, The complexity of risk stratification in older patient candidate to non-cardiac surgery , Monaldi Archives for Chest Disease: Vol. 78 No. 3 (2012): Cardiac series
- Francesco Vetta, Gabriella Locorotondo, Giampaolo Vetta, Maria Mignano, Sonia Bracchitta, Prognostic impact of frailty in elderly cardiac surgery patients , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Bruno Amato, Mario Santoro, Giuseppe Giugliano, Giuseppe Servillo, Veronica Di Nardo, Lorenza Di Domenico, Rita Compagna, Raffaele Izzo, Outcomes after non-cardiac surgery: Mortality, complications, disability, and rehospitalization , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Mahmood Shirzad, Abbasali Karimi, Seyed Hossein Ahmadi, Mehrab Marzban, Mokhtar Tazik, Hermineh Aramin, Predictors and Early Outcome of Prolonged Mechanical Ventilation in Contemporary Heart valve Surgery , Monaldi Archives for Chest Disease: Vol. 74 No. 1 (2010): Cardiac series
- Gennaro Ismeno, Antonio Falco, Francesco Paolo Tritto, Antonio d’Angelo, Francesco Longobardi, Girolamo Damiani, Joseph Marmo, Rosario Gregorio, Luigi Piazza, The use of “LAST†operation in high risk patient , Monaldi Archives for Chest Disease: Vol. 66 No. 1 (2006): Cardiac series
You may also start an advanced similarity search for this article.
