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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2015012263
pages 179-200

A Floating Thrombus Anchored at the Proximal Anastomosis of a Woven Thoracic Graft Mimicking a Genuine Aortic Dissection

Bin Li
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Axe Medecine Regeneratrice, Centre de Recherche du CHU, Quebec, QC, Canada; Department of Vasular Surgery Changhai Hospital, Secondary Military Medical University, Shanghai, China
Bing Liu
Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, China
Yijun Fu
Key Laboratory of Textile Science and Technology of the Ministry of Education, College of Textile, Donghua University, Shanghai, China
Olexandr Bondarenko
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Division of Regenerative Medicine, CHU de Quebec Research Centre, Quebec, QC, Canada
Alain Verdant
Department of Cardiovascular Surgery, Sacre-Coeur Hospital, Montreal and Department of Surgery, Universite de Montreal, Montreal, Quebec City, Canada
Olivier Rochette-Drouin
Department of Surgery, Laval University and Division of Regenerative Medicine CHU de Quebec Research Center, Quebec, Quebec City, Canada
Jing Lin
Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai, PR. China
Jean-Michel Bourget
Departments of Surgery and Radiology, Faculty of Medicine, Laval University, Axe Medecine Regeneratrice, Centre de Recherche, CHU, Quebec, (QC) Canada
Randolph Guzman
Vascular Surgery, St. Boniface General Hospital and Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
Lu Wang
Key Laboratory of Textile Science and Technology of the Ministry of Education, College of Textile, Donghua University, Shanghai, China
Ze Zhang
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Axe Medecine Regeneratrice, Centre de Recherche du CHU, Quebec, QC, Canada
Yvan Douville
Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec
Lucie Germain
Departments of Surgery and Radiology, Faculty of Medicine, Laval University, Axe Medecine Regeneratrice, Centre de Recherche, CHU, Quebec, (QC) Canada
Zaiping Jing
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, P.R. China
Robert Guidoin
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Axe Medecine Regeneratrice, Centre de Recherche du CHU, Quebec, QC, Canada

ABSTRACT

An aortoesophageal fistula following surgery for a ruptured 6.6-cm thoracic aneurysm in a 69-year-old female was repaired using a 34-mm woven prosthetic graft. A follow-up computed tomography (CT) scan at 10 days postoperatively revealed a dissection-like picture in the region of the graft, which was treated conservatively. The patient eventually died from sepsis and multiorgan failure. At autopsy, the graft was retrieved in situ and studied by detailed gross, microscopy, and scanning electron microscopy (SEM) examination. Gross observation confirmed that the dissection resulted from the rolling of the internal capsule downstream. A massive thrombus anchored at the proximal anastomosis and held by a narrow head was also noted. The thrombus demonstrated reorganization in the area of the anastomosis, with a false lumen in its distal half. The reminder of the thrombus consisted of layered fibrin. After gross examination, the fabric graft was found to be flawless. Additional detailed studies were also done using microscopy, SEM, and gross examination.