Late aortic aneurysm after supravalvar aortic stenosis repaired with autologous pericardial patch

We present a patient with a late aortic root aneurysm subsequent to an autologous pericardial patch repair of congenital supravalvar aortic stenosis (SVAS) performed 20 years earlier. There have been no reports of this complication to date, to our knowledge, and the mechanism of aneurysm formation after use of autologous pericardium is not well known. We presume that nonglutaraldehyde fixation and residual distal aortic arch stenosis contributed to aneurysm formation. We highlight the importance of correct selection of patch material, especially when used in the systemic circulation, if durable long-term outcomes are to be achieved.