Transfemoral control of ruptured aortic pseudoaneurysm at aortic root reoperation

Median sternotomy in the setting of aortic pseudoaneurysm and/or rupture is hazardous, requiring technical modifications to prevent exsanguination. Free aortic disruption, particularly when accompanied by aortic regurgitation, presents a particularly challenging situation. The critical issue is to protect the brain and heart while obtaining control of the aorta. We report management of such a case using transfemoral balloon aortic occlusion.