Surgical management of pseudoaneurysm after subclavian artery-to-descending aorta bypass in an adult patient with aortic coarctation.

BACKGROUND

Coarctation of the aorta is a relatively common congenital heart defect. Various operative techniques have been proposed for aortic coarctation repair, which are tailored to individual patient circumstances. However, regardless of the chosen surgical approach, some patients may develop late thoracic pseudoaneurysms. Repeated surgery with a left thoracotomy increases the risk of lung injury and bleeding due to adhesions and rich collateral blood circulation.

CASE PRESENTATION: The patient underwent subclavian artery descending aortic bypass surgery for coarctation of the aorta at the age of 22 years and developed a pseudoaneurysm 30 years after bypass surgery. From the available surgical options for this condition, we selected total arch replacement using a frozen elephant trunk. The outcomes were excellent.

CONCLUSIONS

Depending on each patient's circumstances, revision surgery using the frozen elephant trunk technique can be a viable option.