A 61-year-old female on hemodialysis with chronic renal failure presented with hemoptysis 10 years after replacement of the distal arch and the descending aorta. Computed tomography showed hematoma around the prosthetic graft and intrapulmonary hemorrhage adjacent to the graft. At emergency open surgery, perforation was revealed in the distal portion of the graft. It was considered to be caused by the friction between the surrounding calcified aortic wall and the graft. The ruptured graft was successfully replaced.
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