SUPRAVALVULAR AORTIC-STENOSIS AFTER REPLACEMENT OF THE ASCENDING AORTA

The composite graft technique for replacement of the ascending aorta in patients with aortic dissection or ascending aortic aneurysm has become widely accepted.1 Pseudoaneurysm formation secondary to dehiscence of the suture line at the coronary anastomosis and proximal or distal graft anastomosis can occur. This potentially lethal complication has been reported to occur in 7 to 25% of patients with composite grafts and requires early detection and management.2 We describe a patient in whom a huge anfractuous and partially thrombosed pseudoaneurysm around an ascending aortic Dacron® graft resulted in external compression and severe obstruction of the graft with congestive heart failure. Successful surgical correction was performed. Different imaging techniques for the diagnosis of pseudoaneurysm were used. The few reported cases are revised. © 1992.