Dehiscence of a Composite Aortic Graft and Pseudoan- eursym Late After a Bentall Operation

A 32-year-old female patient with previous Bentall operation and mitral valve repair surgery due to severe aortic insufficiency, mitral valve insufficiency, and ascending aortic aneurysm was admitted to our hospital with serious dyspnea, fatigue, and mild chest pain. Two-dimensional echocardiography demonstrated a markedly dilated basal aorta and cardiac chambers. Thoracic computed tomography scan highlighted a pseudoaneurysm, 14.5 cm in diameter (Figure 1). Urgent surgery was planned. The operation was performed under deep hypothermic cardiopulmonary bypass (arterial and venous line in the right femoral artery and vein). A large aortic pseudoaneurysm was demonstrated arising from the dehiscence of the proximal graft anastomosis (Figure 2). The composite graft did not require replacement, and it was possible to simply re-suture the composite graft and directly close the tear. The postoperative course was uneventful with no further evidence of leak from the anastomotic sites

Dehiscence Of A Composite Aortic Graft And Pseudoaneursym Late After A Bentall Operation

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Is Double-Blinding Possible While Administering Fluids In The Intensive Care Unit?

PubMe

Plio-Quaternary kinematic development and paleostress pattern of the Edremit Basin, western Turkey

The Edremit Basin and Kazdag High are the most prominent morphological features of the Biga Peninsula in northwest Anatolia. There is still no consensus on the formation of Edremit Basin and debates are on whether the basin evolved through a normal, a right-lateral or a left-lateral strike-slip faulting. In this study, the geometric, structural and kinematic characteristics of the Edremit Basin are investigated to make an analytical approach to this problem. The structural and kinematic features of the faults in the region are described according to field observations. These fault-slip data derived from the fault planes were analyzed to determine the paleostress pattern of faulting in the region. According to the performed analysis, the southern end of the Biga Peninsula is under the influence of the ENE-WSW-trending faults of the region, such as the Yenice-Gonen, the Edremit, the Pazarkoy and the Havran-Balikesir Fault Zones. The right step-over geometry and related extension caused to the development of the Edremit Basin as a transtensional pull-apart basin between the Havran-Balikesir Fault Zone and the Edremit Fault Zone. Field observations showed that the Plio-Quaternary faults at the Edremit Gulf and adjacent areas are prominently right-lateral strike-slip faults. Our paleostress analyses suggest a dominant NE-SW extension in the study area, as well as NW-SE direction. This pattern indicates the major effects of the North Anatolian Fault System and the component of Aegean Extensional System in the region. However, our kinematic analysis represents the dominant signature of the North Anatolian Fault System in basin bounding faults. The field observations and kinematic findings of this study are also consistent with the regional GPS, paleomagnetic and seismological data. This study concludes that the North Anatolian Fault System is the prominent structure in the current morphotectonic framework of the Edremit Gulf and adjacent areas. (C) 2016 Elsevier B.V. All rights reserved