Left ventricular pseudoaneurysm after ascending, arch and descending aortic replacement with Evita Open Plus® prosthesis

Methods A 71 year old male with aortic aneurysm was referred for consideration of surgery. The patient comes to the emergency department to present an acute left chest pain. He was a history of duodenal ulcer and arterial hypertension. Rx thorax demonstrated mediastinal widening compatible with giant aortic aneurysm. The echocardiogram (TTE) confirmed normal sized cardiac cavities and ascending aortic aneurysm. Aortography presented severe dilatation of ascending thoracic aorta with moderated aortic regurgitation. CT Angiography established supra-aortic ascending aneurysm with maximum dimension of 53 mm, 65 mm arch aneurysm and descending 106 mm in the transverse plane. Upper medial resternotomy, cardiopulmonary bypass and circulatory arrest complete with moderated hypothermia were performed as well as ascending aorta and arch replacement with reimplantation of the supraaortic trunks by hybrid prosthetic Evita Open Plus 33.