Levent SALTIK, Gürkan ÇETİN, Ahmet ÖZKARA, Özge KÖNER

Pediyatrik bir hastada asandan aort psödoanevrizması

Dokuz aylık infant, ventriküler septal defekt onarımını izleyen ikinci ayda dispne ve perikardiyal kist olarak tanımlanan mediastinal kitle nedeniyle hastanemize başvurdu. Akciğer grafisinde mediastinal genişleme, bilgisayarlı tomografide scan incelemesinde sternum ile kalp arasında sağ atriyuma bası yapan, heterojen dansitede büyük bir kitle görüldü. Transtorasik ekokardiyografi ile yapılan incelemede 4x4.5 cm boyutlarında, içinde hematom olan bir kitle gözlendi. Operasyon sırasında yapılan transözefageal ekokardiyografi ile asandan aortadan kitleye doğru türbülan, devamlı kan akımını ve asandan aort üzerindeki defekt gösterildi. Sternum açıldığında önceki ameliyata ait kardiyopleji kanülasyon yerinden gelişen psödoanevrizma görüldü. Fistül 6/0 prolen dikiş ile onarıldı. Hasta sorunsuz bir şekilde hastanemizden taburcu edildi.

Pseudoaneurysm of the ascending aorta in a pediatric patient

A 9-month-old infant admitted to our hospital with symptoms of dispnea and a mass defined as pericardial cyst two months after the ventricular septal defect repair. Chest film showed a widened upper mediastinum. Computerized tomography scans revealed a large mass with heteregenous density between the sternum and heart that compressed the right atrium. Two dimentional transthoracic echocardiography showed a 4x 4.5 cm sized mass with hematoma inside. Intraoperative transeosophageal echocardiography revealed an abnormal continuous blood flow directed from the ascending aorta to the mass. At the operation a false aneurysm originating from the former cardioplegic cannulation site was observed. The fistula was sewn with 6/0 prolene sutures. The patient recovered uneventfully.

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