Post-Coarctectomy Pseudoaneurysm with Recurrent Coarctation Treated with Open Surgery: A Comprehensive Literature...

Introduction: Patch aortoplasty for aortic coarctation may have a high rate of late aneurysm and pseudoaneurysm formation, with an elevated risk of rupture and subsequent mortality when it occurs. Case: A 55-year-old male with irregular follow-up after patch aortoplasty for aortic coarctation 15 years ago, presented with a late post-coarctectomy aortic arch pseudoaneurysm and re-coarctation. Through a redo thoracotomy and under left heart bypass, the pseudoaneurysm and previous patch were partially excised, and reconstruction with interposition of a "Y" shaped Dacron graft was performed, in order to preserve the patency of the left subclavian artery. The postoperative course was uneventful, and at 6 months, the CT-angio control showed adequate graft patency. Comprehensive Literature Review: A comprehensive literature review with the primary focus on the different late complications after CoA repair (post-aortic coarctation aneurysms and recoarctation), and outcomes of open and endovascular approaches was performed. Conclusions: Open surgical repair for post-coarctectomy pseudoaneurysm is feasible with excellent results. However, due to the technical challenges, it may be performed with better results in high-volume aortic centers.