Aortic aneurysm 31 years after coarctation repair with direct anastomosis: Surgical repair avoiding circulatory arrest

Background: Despite primary success, 9% of patients develop aortic (pseudo)aneurysms after surgical repair of aortic coarctation at or near the site of repair late after operation. Case Study: A chest X-ray in a 32-year-old asymptomatic man, 31 years after coarctation repair, depicted a ballooning of the distal aortic arch. A multislice CT confirmed an aneurysm. The aneurysm was resected using selective head perfusion. Conclusion: At follow-up of patients after coarctation repair, one should anticipate aneurysm formation, even decades after successful surgery and even if clinically silent. Therefore, the chest X-ray should be part of the follow-up examination. Deep hypothermic circulatory arrest can be avoided in selected patients.