Management of a pulsatile mass coming through the sternum. Pseudoaneurysm of ascending aorta 35 years after repair of tetralogy of Fallot.

We describe a case of an ascending aortic pseudoaneurysm during long-term follow-up after repair of tetralogy of Fallot (TOF). The patient had a complex cardiac surgical history with multiple operations for the correction of TOF. The aneurysm was located at the presumed site of previous aortic cannulation. It was initially treated percutaneously with an Amplatzer septal occluder device, with limited early success. After 12 months it was found to have migrated into the sac and open surgical repair was undertaken successfully.