Pseudoaneurysm of graft–graft anastomosis of a hand-sewn branched graft: a case report

BACKGROUND: Pseudoaneurysm of graft–graft anastomosis is an extremely rare but potentially fatal complication after thoracic aorta replacement with a prosthetic graft. We report a case of pseudoaneurysm at the graft–graft anastomosis of a hand-sewn branched graft. CASE PRESENTATION: A 65-year-old man underwent total arch replacement with a hand-sewn branched graft for Stanford type A acute aortic dissection 22 years ago. During follow-up, serial CT scans showed a pseudoaneurysm on the branched graft which warranted reintervention. Surgical repair involved direct suture of multiple bleeding points which were found at the sites of the hand-sewn branches anastomosis. The postoperative course was uneventful, and no signs of bleeding were observed by CT after the reoperation. CONCLUSIONS: Long-term follow-up is essential to detect late complications at the site of hand-sewn anastomosis.