Huge ascending aortic pseudoaneurysm 13 years after Bental surgery with tube graft

Pseudoaneurysms of the ascending aorta are rare, disastrous complications of surgical manipulation of the aorta and its surroundings. They frequently require emergency surgical intervention due to a high risk of sudden rupture and hemorrhage. We herein present the case of a pseudoaneurysm (130 mm in diameter) of the ascending aorta with a compressive effect on the left atrium and right coronary artery ostium at the site of a tube graft implanted 13 years previously via the Bental procedure in a 34 year-old man. The susceptibility of these pseudoaneurysms to silently increase in size through the years leads to a delayed diagnosis, with an increased risk of rupture and mortality, necessitating long-term follow-ups with a view to detecting it in the initial stages, when it is easier to perform surgical or endovascular interventions with a lower risk of mortality.