Abstract
A 55 year old man treated when aged 12 with a Dacron patch aortoplasty for coarctation, presented with hoarseness. (A) Computed tomography angiography showed a 67 mm post-coarctation aneurysm, angulated hypoplastic aortic arch (AA), ectatic proximal left subclavian artery (LSA), thickened ligamentum arteriosus (LA), and bicuspid aortic valve (posterior view). Re-thoracotomy was performed through the left fourth intercostal space with lysis of tight adhesions. Aneurysmectomy with graft interposition (14 mm Dacron) and LSA revascularisation was performed (B). Banding of the proximal anastomosis was added owing to the very fragile AA wall. Post-operative hospitalisation was uneventful.Image 1
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