Hybrid Repair for an Anastomotic Pseudoaneurysm of the Bicarotid Trunk

Abstract

Herein, we report a rare case of a pseudoaneurysm at the anastomotic site of the bicarotid trunk after thoracic aortic graft replacement. A 53-year-old man with Marfan syndrome underwent a three-stage operation involving aortic root reimplantation and ascending aortic replacement ; aortic valve replacement and total arch replacement ; and descending aortic replacement performed for type A dissection combined with an aberrant right subclavian artery. Two years after total arch replacement, the patient presented with hoarseness and a computed tomography scan revealed an anastomotic pseudoaneurysm of the common trunk of the left and right carotid arteries. A right axillary artery-common carotid artery bypass was performed, with simultaneous insertion of a vascular stent graft from the left common carotid artery to the anastomotic site. Cervical bypass and stent implantation were both performed without shunting. He was discharged home without any neurological complications.