Perforation of a Vascular Prosthesis Caused by Calcified Foci on the Aortic Cuff Remaining Late after Thoracic Aortic Aneurysm Repair

Abstract

An 85-year-old woman presented with abnormality on lung cancer screening. The distal arch and descending thoracic aortic aneurysm were surgically repaired using a woven dacron graft (Gelweave™, Vascutec) at 73 years old. Computed tomography showed a proximal anastomotic false aneurysm that expanded to 110 mm in diameter. At the reoperation, the dacron graft showed 2 holes measuring 5 mm in size, apart from the anastomosis that had dehisced without signs of infection. Graft perforation potentially caused by densely calcified foci in the aneurysm cuff was suspected as the primary cause of false aneurysm resulting in dehiscence of the proximal anastomosis.