A Case of Inflammatory Pseudoaneurysm of the Ascending Aorta

Abstract

A 74-year-old man had an inflammatory pseudoaneurysm of the ascending aorta. He was admitted to a local hospital because of loss of appetite. Following intravenous hyperalimentation, he was placed under ventilatory support because of acute respiratory failure. Since his high fever and respiratory failure continued, he was transferred to our hospital. Computed tomography revealed a sealed rupture of an aneurysm in the ascending aorta. During the operation, we identified the ascending aortic aneurysm but it was very tightly attached to the surrounding wall in the perianeurysmal space. To avoid excessive hemorrhage, we closed the communication between the aneurysm and the aorta with a Dacron graft patch under deep hypothermia with circulatory arrest. He was discharged 42 days after operation without any complications. A pathological evaluation of the aneurysmal wall revealed an inflammatory pseudoaneurysm with a thick and inflammatory infiltration in the adventitia.