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A and B. CT scan showing the left upper lobe tumor mass infiltrating the main left pulmonary artery and the bronchus. Fig. 1C. Red arrows highlighting the position of the atherosclerotic plaque. Fig. 1D and E. Revealing the endograft stent placed in the aorta by the interventional radiologist through the femoral artery. CT: computer tomography.
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He underwent chest X-ray and a CT scan with enhancement, which showed a mass of 34 x 32 mm located in the left upper lobe of the lung, infiltrating the left main pulmonary artery and the left bronchus (Fig. 1). At the beginning of the operation, during the mobilization of the mass, a 5-mm aortic rupture occurred in the adventitia due to the presence of an atherosclerotic calcified plaque at this level (Fig. 1C). Patient conditions stayed persistently stable and after 15 min the bleeding was under controlled, however, for the high risk of an another unexpected bleeding, the thoracic wall was closed and the patient intubated was transferred urgently to the interventional operating room where an endovascular stent was placed from the left subclavian artery to the descending aorta using percutaneous retrograde common femoral artery access (Fig. 1D and E).
A. The chest X-ray on the day of discharge from the hospital (sixth postoperative day), at one month (2B) and four months after surgery (2C).
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Chest tubes were removed on the third postoperative day, and the patient was discharged after six days from surgery with no morbidities (Fig. 2A). Chest X-rays at one-month and four-month follow-up from surgery (Fig. 2B-C) revealed no complications.