GIANT ASCENDING AORTIC ANEURYSM PENDING RUPTURE

Abstract

Aneurysm of the aorta refers to abnormal dilatation of a portion of the aortic wall related to its weakening from any cause. It is a serious cardiovascular problem that can present as an acute life-threatening emergency due to dissection and rupture of the aortic wall. Though most common in the abdominal aorta, any portion of the vessel can be affected, with clinical features relevant to the area and extent of involvement. The risk of rupture increases with aneurysmal dilatations exceeding 5 cm, whereas giant aneurysms measure above 13 cm, and are rare. Reportedly, only 10-25% of patients survive rupture because of increased pre- and post-operative mortality.
A 40 years young hypertensive male presented to Rehman Medical Institute, Peshawar, Khyber Pakhtunkhwa, in December 2016, with symptomatic giant aortic aneurysm involving root and ascending aorta with aortic regurgitation. He was complaining of chest pain and dyspnea that was gradually increasing over time. Due to risk of rupture the patient was prepared for surgery and Bentall’s procedure of aortic root replacement with coronary arteries button re-implantation was performed with successful postoperative uneventful course.