Successful hybrid TEVAR for distal anastomotic pseudoaneurysm and coarctation following previous palliative left subclavian artery to descending aorta bypass: A case report.

Introduction: Anastomotic pseudoaneurysm is one of the most common but catastrophic complications in coarctation of the aorta (CoA); this is equally true even if the initial surgery is not directly related to the coarctation. Redo open heart surgery is usually required for the pseudoaneurysm; however, redo surgery remains challenging with high morbidity and mortality rates.

Presentation Of Case: A 38-year-old woman with CoA, who had undergone left subclavian artery (LSCA) to descending aorta bypass 21 years prior, was referred to us for the treatment of distal anastomotic pseudoaneurysm. Zone 2 thoracic endovascular aortic repair (TEVAR) with LSCA debranching was performed to exclude the distal anastomotic pseudoaneurysm and expand the CoA using a stent graft. The patient completely recovered and resumed work without delay.

Discussion: In patients who require surgical treatment for both pseudoaneurysm and CoA, hybrid TEVAR can be an alternative surgical option instead of conventional open repair.

Conclusion: TEVAR for concomitant pseudoaneurysm and native CoA is feasible and less invasive, especially for young patients who have to resume work early after surgery.