Abstract
BackgroundIn adult patients with primary or recurrent coarctation of the aorta (CoA), extra-anatomic bypass grafting (EABG) has been widely used as a surgical treatment option. However, there have been few reports on pseudoaneurysms (PAs) of the distal anastomotic sites after extra-anatomic bypass for CoA.Case presentationA 51-year-old man with hemoptysis was transferred to our hospital. Twenty years ago, he had undergone EABG from the ascending to the descending aorta (ascending-to-descending EABG) for CoA with right aortic arch. Eight years ago, he underwent thoracic endovascular aortic repair (TEVAR) for the ruptured PA on the distal anastomotic site of the EABG. Contrast-enhanced computed tomography scans revealed recurrent ruptured PA on the distal anastomotic site of the EABG. Therefore, we decided to replace the descending aorta, followed by end-to-side anastomosis of the EABG to the replaced descending aorta. However, due to massive adhesion of the lung to the EABG and PA, we performed transection of the descending aorta to decompress the PA. The postoperative course was uneventful, and the patient is doing well 5 months after surgery.ConclusionsAortic transection between the CoA and the distal anastomosis site may be a useful additional procedure in patients previously treated with TEVAR for PAs in the distal anastomosis site after EABG.
Highlights
In adult patients with primary or recurrent coarctation of the aorta (CoA), extra-anatomic bypass grafting (EABG) has been widely used as a surgical treatment option
Aortic transection between the CoA and the distal anastomosis site may be a useful additional procedure in patients previously treated with thoracic endovascular aortic repair (TEVAR) for PAs in the distal anastomosis site after EABG
We report the case of a patient who was treated with proximal aortic transection for a recurrent and ruptured PA on the distal anastomotic site of EABG that had previously
Summary
Aortic transection between the CoA and distal anastomosis site may be a useful additional procedure for PAs in the distal anastomosis site after EABG in patients previously treated with TEVAR. Abbreviations CoA: Coarctation of the aorta; EABG: Extra-anatomic bypass grafting; PA: Pseudoaneurysm; TEVAR: Thoracic endovascular aortic repair; CT: Computed tomography.
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