Floppy aortic graft reconstruction for germ cell tumor invasion of the infrarenal aorta

• Published in: Journal of vascular surgery Vol. 37; no. 4; pp. 889 - 891
• Main Authors: Jerius, John T., Elmajian, Donald A., Rimmer, David M., Spires, Kevin S.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2003; Elsevier
• Subjects: Adult; Aneurysm, False - etiology; Aneurysm, False - surgery; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Aorta, Abdominal - surgery; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis Implantation - methods; Cardiology. Vascular system; Diseases of the aorta; Germinoma - drug therapy; Germinoma - pathology; Germinoma - surgery; Humans; Male; Medical sciences; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Staging; Reoperation; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology; Testicular Neoplasms - surgery; Vascular Neoplasms - drug therapy; Vascular Neoplasms - secondary; Vascular Neoplasms - surgery; Ethylene terephthalate polymer; Human; False aneurysm; Prosthesis; Clinical form; Cardiovascular disease; Metastasis; Malignant tumor; Testicle; Arterial disease; Vascular disease; Case study; Plasty; Surgery; Aorta; Male genital diseases; Aortic disease; Testicular diseases
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1067/mva.2003.156

Significant aortic invasion by metastatic nonseminomatous germ cell tumors can present difficult problems intraoperatively in attempted curative retroperitoneal lymph node dissection. Aortic replacement with Dacron graft has been a successful method of dealing with this predicament. We describe a new approach of intraoperative floppy aortic graft reconstruction in a young patient with testicular germ cell cancer in whom a 14 cm pseudoaneurysm involving the infrarenal aorta developed after four courses of preoperative chemotherapy. This technique prevents significant lower extremity and pelvic ischemia during resection of the aorta and retroperitoneal tumor while providing the urologic surgeon with excellent exposure and minimal interference from the aortic graft. (J Vasc Surg 2003;37:889-91.)