Giant pseudoaneurysm of right subclavian artery presenting with severe respiratory distress

Subclavian artery pseudoaneurysms are rare; and cases involving subclavian artery pseudoaneurysms presenting with compression on trachea leading to breathing difficulty are exceptional. We present a case report of huge subclavian artery pseudoaneurysm presenting with hoarseness of voice, respiratory distress, and aphonia. Patient was operated through median sternotomy, with the incision extended over the swelling. Aortic looping was done before opening the aneurysm. Rent in the right subclavian artery was identified and repaired. Because of the absence of a distal pulsation beyond the repaired site, we placed a reversed saphenous vein graft from the ascending aorta (end-to-side) to the right subclavian artery distal to repaired site (end-to-side). Good pulsation was achieved in the right brachial, right radial, and right ulnar arteries. Patient was extubated after 6 hours in stable condition.