Zhou Ruofan, Wang Yabo, An Qi
Department of Cardiovascular Surgery, West China Hospital of Sichuan University, 37# Guoxue Xiang, Chengdu, 610041, Sichuan, China.
J Cardiothorac Surg. 2025 Jan 3;20(1):4. doi: 10.1186/s13019-024-03281-x.
Pseudoaneurysm after coarctation of the aorta (CoA) repair is a rare but severe complication. Contributing factors may include infection, hypertension, aortic wall weakness, and turbulent blood flow at the repair site.
A 35-year-old male presented with recurrent episodes of epistaxis and dizziness was admitted to the emergency department. He had a history of CoA repair and ventricular septal defect closure 17 years ago. Physical examination revealed elevated blood pressure. Initially, aortic dissection was suspected, but the actual diagnosis was pseudoaneurysm just distal to the left subclavian artery. Surgical intervention involved excision of the pseudoaneurysm and replacement with a new vascular graft via a dual approach of median sternotomy and left thoracotomy. Postoperative recovery was uneventful, and follow-up imaging at one month showed satisfactory aortic morphology.
This case underscores the critical role of precise imaging in differentiating pseudoaneurysms from other lesions in post-CoA repair patients. Pseudoaneurysms can present subtly yet carry substantial risks, making regular imaging follow-up essential for early detection and improved outcomes.
主动脉缩窄（CoA）修复术后假性动脉瘤是一种罕见但严重的并发症。促成因素可能包括感染、高血压、主动脉壁薄弱以及修复部位的血流紊乱。
一名35岁男性因反复鼻出血和头晕发作就诊于急诊科。他17年前有CoA修复和室间隔缺损封堵病史。体格检查发现血压升高。最初怀疑为主动脉夹层，但实际诊断为左锁骨下动脉远端的假性动脉瘤。手术干预包括切除假性动脉瘤，并通过正中胸骨切开术和左胸廓切开术的双重方法用新的血管移植物进行置换。术后恢复顺利，术后1个月的随访影像学检查显示主动脉形态满意。
该病例强调了精确成像在CoA修复术后患者中将假性动脉瘤与其他病变区分开来的关键作用。假性动脉瘤可能表现隐匿但风险巨大，因此定期进行影像学随访对于早期发现和改善预后至关重要。
