[Brachiocephalic Artery Graft Occlusion Caused by Compression from a Pseudoaneurysm at the Proximal Anastomosis After Total Arch Replacement].

A 75-year-old man, who had undergone total arch replacement for a thoracic aortic aneurysm 4 years earlier, presented with transient left hemiplegia and right upper extremity weakness. Contrast-enhanced computed tomography (CT) revealed a large pseudoaneurysm at the proximal anastomosis of the ascending aortic graft, compressing and occluding the brachiocephalic graft. Surgical resection of the pseudoaneurysm and ascending aortic graft replacement with a 1-branched graft were performed. Cardiopulmonary bypass was established via peripheral vessels prior to re-median sternotomy. Thrombi were removed from the brachiocephalic graft, followed by replacement of the ascending aorta with a branched artificial graft for the brachiocephalic artery. The patient was discharged without complications. We report a rare case of transient hemiplegia due to brachiocephalic graft compression by a pseudoaneurysm.