Right heart overload due to pulmonary trunk obstruction after Bentall procedure

摘要

A 72-year-old woman with 4 previous cardiovascular operations, presented with dyspnea at rest and leg edema. Transthoracic echocardiography revealed high right ventricular (110mmHg) and central venous pressure. The pulmonary trunk was compressed by a surrounding mass, and the peak pressure gradient between the right ventricular outflow tract and the pulmonary trunk was 67mmHg, with a peak velocity of 4.1 m-s-1. Enhanced computed tomography disclosed pulmonary trunk obstruction due to the massive extrinsic mass (Figure l(a)). At urgent surgery, the proximal anastomotic suture line of a Bentall procedure was dehisced on the pulmonary trunk side, and a massive hematoma compressed the pulmonary trunk.