Affiliation:
1. Second Affiliated Hospital of Army Medical University, PLA
Abstract
Abstract
Ruptured hepatic artery aneurysms (HAA) can lead to acute circulatory decompensation, which is usually fatal. Hence, HAAs must be identified and addressed rapidly to reduce the morbidity and mortality. Here, we report a 45-year-old female patient who was diagnosed with rheumatic heart disease, moderate mitral and aortic valve stenosis and regurgitation, and HAA. She underwent mitral and aortic valve replacements under cardiopulmonary bypass (CPB). At the end of the surgery, the patient’s blood pressure level plummeted, and abdominal distension was observed. An abdominal ultrasound suggested a ruptured HAA. After an emergency multidisciplinary consultation, selective hepatic arteriography through a right femoral artery approach and exploratory laparotomy were performed, which confirmed the diagnosis of ruptured HAA. After surgery, the patient was saved and stable. We reviewed the literature and found few reports of cases of heart valve surgery under CPB complicated by intraoperative HAA rupture. This case report shares our experience of anesthesia management in such cases.
Publisher
Research Square Platform LLC
Reference20 articles.
1. Open and endovascular repair of hepatic artery aneurysm: two case reports and review of the literature;Nathan DP;Vascular,2011
2. Natural history and management of splanchnic artery aneurysms in a single tertiary referral center;Erben Y;J Vasc Surg,2018
3. The minimally invasive management of visceral artery aneurysms and pseudoaneurysms;Fankhauser GT;J Vasc Surg,2011
4. Aneurysm of the hepatic artery. Report of five cases with a brief review of the previously reported cases;Guida PM;Surgery,1966
5. Shelton J, Raviraj SA, Case Report. Hepatic artery pseudoaneurysm causing life-threatening haemobilia.International Journal of Surgery Case Reports. 2021;86.