Abstract
A visceral artery aneurysm (VAA) is a very rare and lethal vascular anomaly with dramatic consequences. The overall incidence of VAA is 5% of all abdominal artery aneurysms. The involvement of the superior mesenteric artery is even rare (incidence of 3.5–8% of all VAA). The development of superior mesenteric artery pseudoaneurysm following cardiac surgery is scarcely reported in the literature. We report a case of contained rupture of the superior mesenteric artery with no distal flow causing acute mesenteric ischemia (AMI) following double heart valve replacement surgery.
Similar content being viewed by others
References
Golitaleb M, Golaghaie F, Mousavi MS, Harorani M, Bakhshande Abkenar H, Haghazali M, et al. Gastrointestinal complications after cardiac surgery. Iran Heart J. 2019;20:56–61. https://doi.org/10.1016/s0734-3299(08)70107-2.
Ohri SK, Desai JB, Gaer JA, Roussak JB, Hashemi M, Smith PL, et al. Intraabdominal complications after cardiopulmonary bypass. Ann Thorac Surg. 1991;52:826–31. https://doi.org/10.1016/0003-4975(91)91219-L.
Christenson JT, Schmuziger M, Maurice J, Simonet F, Velebit V. Postoperative visceral hypotension the common cause for gastrointestinal complications after cardiac surgery. Thorac Cardiovasc Surg. 1994;42:152–7. https://doi.org/10.1055/s-2007-1016478.
Chaer RA, Abularrage CJ, Coleman DM, Eslami MH, Kashyap VS, Rockman C, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020;72:3S-9S. https://doi.org/10.1016/j.jvs.2020.01.039.
Teixeira PG, Thompson E, Wartman S, Woo K. Infective endocarditis associated superior mesenteric artery pseudoaneurysm. Ann Vasc Surg. 2014;28:1563.e1-1563.e5. https://doi.org/10.1016/j.avsg.2014.03.032.
Lorelli DR, Cambria RA, Seabrook GR, Towne JB. Diagnosis and management of aneurysms involving the superior mesenteric artery and its branches: a report of four cases. Vasc Endovascular Surg. 2003;37:59–66. https://doi.org/10.1177/153857440303700108.
Alvares JF, Parsonnet V, Brief DK. Mycotic aneurysm of the superior mesenteric artery. Am J Surg. 1966;111:237–40. https://doi.org/10.1016/0002-9610(66)90248-0.
Guirgis M, Xu JH, Kaard A, Mwipatayi BP. Spontaneous superior mesenteric artery branch pseudoaneurysm: a rare case report. EJVES Short Rep. 2017;1:1–4. https://doi.org/10.1016/j.ejvssr.2017.09.001.
Tarhan NC, Coskun M, Kayahan EM, Yildirim E, Yucel E. Regression of abdominal visceral aneurysms in polyarteritis nodosa: CT findings. AJR Am J Roentgenol. 2003;180:1617–9.
Lerkvaleekul B, Treepongkaruna S, Ruangwattanapaisarn N, Treesit T, Vilaiyuk S. Recurrent ruptured abdominal aneurysms in polyarteritis nodosa successfully treated with infliximab. Biologics. 2019;13:111–6. https://doi.org/10.2147/BTT.S204726.
Vicari AM, Guisti MC, Luoni R, Shaw PJ, Bates D, CartIidge NEF, et al. Neurologic and nemopsychological morbidity following major surgery. Stroke. 1987;18:892–5.
Chung JW, Ryu SH, Jo JH, Park JY, Lee S, Park SW, et al. Clinical implications and risk factors of acute pancreatitis after cardiac valve surgery. Yonsei Med J. 2013;54:154–9. https://doi.org/10.3349/ymj.2013.54.1.154.
Tulsyan N, Kashyap VS, Greenberg RK, Sarac TP, Clair DG, Pierce G, et al. The endovascular management of visceral artery aneurysms and pseudoaneurysms. J Vasc Surg. 2007;45:276–83. https://doi.org/10.1016/j.jvs.2006.10.049.
Funding
U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Nil. The authors declare that they have no conflict of interest.
Informed consent
A written informed consent was obtained from the patient authorising radiological examination, photographic documentation, and surgery. He was also informed that the data concerning the case would be submitted for publication and he consented.
Statement of human and animal rights
There were no infringements of human/animal rights in this investigation.
Ethical committee approval
Since this is a case report, we did not take the ethical clearance as there was no change in the treatment protocol.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Patel, H., Patel, A., Seth, M. et al. A case of contained rupture of the superior mesenteric artery with no distal flow causing mesenteric ischemia following double heart valve replacement surgery. Indian J Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s12055-023-01649-7
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s12055-023-01649-7