Pseudoaneurysm of the Ascending Aorta

A 37 year-old woman underwent aortic and mitral valve replacement and 3 months later developed a pseudoaneurysm from the anterior aspect of the proximal ascending aorta (AA). The pseudoaneurysm was approached through a redo-median sternotomy, on cardiopulmonary bypass (CPB), moderate hypothermia, and repaired successfully using autologous pericardium. The standard approach to such pseudoaneurysm is a CBP and hypothermic circulatory arrest prior to mid- sternotomy, and repair or replacement of the AA; but when a pseudoaneurysm arises from a narrow ostium on the anterior aspect of the AA, as in this case, it can be repaired under CPB with moderate hypothermia.