Abstract
A 64-year-old man was admitted to our hospital for acute congestive heart failure. Computed tomography (CT) images revealed an aortic arch aneurysm and a fistula between the arch aneurysm and pulmonary artery. Doppler echocardiography demonstrated aortopulmonary shunting with a Qp/Qs of 3.1. After the patient’s renal and liver dysfunction were treated with dehydration, his aortic arch was replaced with a Hemashield graft and the aortopulomonary fistula was directly sutured using 4-0 polypropylene interrupted sutures and pledget reinforcement under cardiopulmonary bypass, with deep hypothermic circulatory arrest and antegrade selective cerebral perfusion. Postoperative CT images showed that the aortic arch replacement was successful, and the LR shunt had disappeared. The patient was discharged on postoperative day 30.
