65-godišnji muškarac s dakronskim tubularnim graftom uzlazne aorte i mehaničkim aortalnim zaliskom („kompozitni graft“), zaprimljen je na Neurološki odjel zbog tranzitorne ishemijske atake. Sedam mjeseci prije ove hospitalizacije, doživio je prometnu ezgodu s tupom povredom prsišta. Radiografijom prsnoga koša i ranstorakalnim ehokardiografskim pregledom učinjenim neposredno po nezgodi, nisu zabilježene patološke promjene. Prilikom prijama, bolesnik je bio bez simptoma, stabilnih hemodinamskih parametara.
Unatoč tome, ehokardiografskim pregledom je zabilježena hiscencija kompozitnog grafta aorte u području proksimalne anastomoze s posljedičnim nastankom pseudoaneurizme u prostoru između aortne stijenke i dakronskog grafta. Pseudoaneurizma je slobodno municirala s izlaznim traktom lijeve klijetke. Bolesnik je žurno upućen na kardiokirurški zahvat. Nažalost, umro je naglom smrću, tijekom pripreme za operativni zahvat. Prikazani slučaj upućuje na to da je, zbog odgođenog nastajanja pseudoaneurizme i dehiscencije
dakronskog grafta, ehokardiografsko praćenje poželjno u svih olesnika, prethodno podvrgnutih „rekonstrukciji po Bentallu“, tijekom nekoliko mjeseci nakon tupe povrede prsišta.A 65-year old man with bileaflet mechanical aortic prosthesis and a Dacron tubular aortic graft was admitted at the Department of Neurology due to transient ischemic attack. Seven months before admission, he had suffered a car accident with blunt thoracic trauma. A chest X-ray and transthoracic echocardiogram performed at the time of the accident reported no abnormalities. At admission, he was presented as a asymptomatic, hemodynamically stable patient. However, echocardiography showed dehiscence of the valved aortic conduit from the native aortic annulus at the proximal anastomosis site, and free communication between the left ventricular outflow tract and the periconduit cavity. The patient was referred to a cardiac surgeon.
Unfortunately, he experienced sudden death before the scheduled operation. Our case suggests that, because of delayed development of pseudoaneurysm and conduit dehiscence, echocardiography follow-up is recommended in patients after Bentall reconstruction within several months after the blunt chest trauma
