Download Aorta Graft Leak - WVU School of Medicine

Case Presentation:
Aortic Graph Leak
Kristina Addie, MS3
Vascular Surgery
August 9, 2015
81 y.o. White Male followed by Dr. Kumar Pillai
CC: AAA rupture from EVAR in 2012
HPI: Patient was a transfer from Mon General for
ruptured AAA. He had EVAR procedure December
13, 2012 completed by Dr. Kumar Pillai. In April of
this year he was noted to have an endoleak. He
presented at Mon General with abdominal pain and
upon CT scan was shown to have developed an
retroperitoneal hematoma. He was then transferred
here directly to the OR for emergent operation
performed by Dr. Alexandre D’Audiffret.
PMH:
- HTN
- Myocardial infarctions: 1976 and 1993
- CAD
- Dysrhythmia, ablation in 2003
- AAA Aneurysm first noted in 2000
- DM type 2
Family Hx:
- mother: deceased 69- Stroke , emphysema
- Brother: MI , alive and well
- Son: Diabetes, HTN
Social Hx:
Tobacco: 25 pack years, quit 11/28/1975
No ETOH use
Medications:
Aspirin 81 mg Delayed Release (E.C.) PO, 1 qd
B complex vitamins PO , 1 qd
CALCIUM CARBONATE/VITAMIN D2 (CALCIUM 500 WITH VITAMIN D ) PO
CALCIUM CARBONATE/VITAMIN D3 (CALCIUM 600 + D) PO 1 qd
Carvedilol (COREG) 6.25 mg Tab , 2 tabs bid
Clopidogrel (PLAVIX) 75 mg PO, ½ tab qd
COQ10 SG 100, PO qd
CRESTOR, PO 20 mg qd
Dofetilide (TIKOSYN) 250 mcg PO bid
Ferrous sulfate (FERATAB) 324 mg (65 mg iron), Delayed Release (E.C.) PO qd before
breakfast
LANTUS SC 30 Units SQ Every evening
LASIX, PO 80 mg qd
LEVOTHROID , PO 75 mcg QD
Loratadine (CLARITIN) 10 mg PO qd
MULTIVITAMIN W-MINERALS/LUTEIN (CENTRUM SILVER ) PO
Nitroglycerin (NITROSTAT) 0.4 mg Sublingual – Every 5 minutes PRN for 3 doses over
15 minutes
NOVOLOG SUBQ -10 Units Subcutaneous route TID before meals.
Omega-3 Fatty Acids-Vitamin E (FISH OIL) 1,000 mg PO
Valsartan (DIOVAN) 160 mg Tab , ½ tab qd
Zinc 50 mg Oral Capsule - PO Every Monday, Tuesday, Thursday and Saturday
Evaluation:
• CT Scan (Abdomen and Pelvis) from Mon
General 8/7/15
• CT Angio Abdomen and Pelvis from 4/21/15