False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare,
but life-threatening complication. In spite of advances in endovascular techniques, surgery remains
the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm
caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred
30 years after replacement of aortic valve and ascending aorta by classical Bentall operation.
A fistula originating from the aneurysmal sac extended across the sternum into the thoracic
subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest
wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal
reconstruction was effective and uneventful.
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