Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report

Abstract Background Aortic dilatation may occur in some patients even after complete repair of tetralogy of Fallot (TOF). The progression rate of the aortic diameter is so slow, and the incidence of aortic dissection is so low that it is suspected that frequent imaging of the aorta may not be necess...

Full description

Saved in:
Bibliographic Details
Main Authors: Yosuke Nishimura, Toru Yasutsune, Shohei Shimajiri, Yuki Jinzai, Eigo Ikushima, Takehiro Kishigami, Tomoya Takigawa
Format: Article
Language:English
Published: Japan Surgical Society 2020-07-01
Series:Surgical Case Reports
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40792-020-00935-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849711261626925056
author Yosuke Nishimura
Toru Yasutsune
Shohei Shimajiri
Yuki Jinzai
Eigo Ikushima
Takehiro Kishigami
Tomoya Takigawa
author_facet Yosuke Nishimura
Toru Yasutsune
Shohei Shimajiri
Yuki Jinzai
Eigo Ikushima
Takehiro Kishigami
Tomoya Takigawa
author_sort Yosuke Nishimura
collection DOAJ
description Abstract Background Aortic dilatation may occur in some patients even after complete repair of tetralogy of Fallot (TOF). The progression rate of the aortic diameter is so slow, and the incidence of aortic dissection is so low that it is suspected that frequent imaging of the aorta may not be necessary. Case presentation We describe an asymptomatic 41-year-old man with hypertension in whom aortic dilatation was accidentally discovered 39 years after TOF repair. He underwent ambulatory follow-up without any difficulty for 21 years after the repair. Contrast-enhanced computed tomography revealed significant aortic dilatation (maximum diameter of 88 mm at the sinus of Valsalva), and echocardiography revealed severe aortic regurgitation, which seemed to progress during the last 18 years without any evaluation or follow-up. The Bentall procedure was successfully performed using a valved graft, under deep hypothermic circulatory arrest with antegrade cerebral perfusion, and his postoperative course was uneventful. Histopathological examination of ascending aorta specimens revealed severe cystic medial degeneration. Conclusions Keeping in mind that a patient with rapid progression of the aortic dilatation after TOF repair exist, periodic follow-up for evaluation of the aorta is essential in patients with TOF.
format Article
id doaj-art-4e272e036e474a4189687fc26e87adca
institution DOAJ
issn 2198-7793
language English
publishDate 2020-07-01
publisher Japan Surgical Society
record_format Article
series Surgical Case Reports
spelling doaj-art-4e272e036e474a4189687fc26e87adca2025-08-20T03:14:40ZengJapan Surgical SocietySurgical Case Reports2198-77932020-07-01611510.1186/s40792-020-00935-5Significant delayed aortic dilatation after tetralogy of Fallot repair: a case reportYosuke Nishimura0Toru Yasutsune1Shohei Shimajiri2Yuki Jinzai3Eigo Ikushima4Takehiro Kishigami5Tomoya Takigawa6Department of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthDepartment of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthDepartment of Surgical Pathology, School of Medicine, University of Occupational and Environmental HealthDepartment of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthDepartment of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthDepartment of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthDepartment of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental HealthAbstract Background Aortic dilatation may occur in some patients even after complete repair of tetralogy of Fallot (TOF). The progression rate of the aortic diameter is so slow, and the incidence of aortic dissection is so low that it is suspected that frequent imaging of the aorta may not be necessary. Case presentation We describe an asymptomatic 41-year-old man with hypertension in whom aortic dilatation was accidentally discovered 39 years after TOF repair. He underwent ambulatory follow-up without any difficulty for 21 years after the repair. Contrast-enhanced computed tomography revealed significant aortic dilatation (maximum diameter of 88 mm at the sinus of Valsalva), and echocardiography revealed severe aortic regurgitation, which seemed to progress during the last 18 years without any evaluation or follow-up. The Bentall procedure was successfully performed using a valved graft, under deep hypothermic circulatory arrest with antegrade cerebral perfusion, and his postoperative course was uneventful. Histopathological examination of ascending aorta specimens revealed severe cystic medial degeneration. Conclusions Keeping in mind that a patient with rapid progression of the aortic dilatation after TOF repair exist, periodic follow-up for evaluation of the aorta is essential in patients with TOF.http://link.springer.com/article/10.1186/s40792-020-00935-5Aortic dilatationAneurysmTetralogy of Fallot
spellingShingle Yosuke Nishimura
Toru Yasutsune
Shohei Shimajiri
Yuki Jinzai
Eigo Ikushima
Takehiro Kishigami
Tomoya Takigawa
Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
Surgical Case Reports
Aortic dilatation
Aneurysm
Tetralogy of Fallot
title Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
title_full Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
title_fullStr Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
title_full_unstemmed Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
title_short Significant delayed aortic dilatation after tetralogy of Fallot repair: a case report
title_sort significant delayed aortic dilatation after tetralogy of fallot repair a case report
topic Aortic dilatation
Aneurysm
Tetralogy of Fallot
url http://link.springer.com/article/10.1186/s40792-020-00935-5
work_keys_str_mv AT yosukenishimura significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT toruyasutsune significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT shoheishimajiri significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT yukijinzai significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT eigoikushima significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT takehirokishigami significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport
AT tomoyatakigawa significantdelayedaorticdilatationaftertetralogyoffallotrepairacasereport