Unusual origin and fistulization of an aortic pseudoaneurysm: “off-pump” surgical repair

Aortic pseudoaneurysm is an unusual complication of cardiac operations. The origin depends on the site of arterial wall disruption. Rupture into the right side of the bronchial tree is an exceedingly rare evolution. Repair is commonly performed using cardiopulmonary bypass. In our report a male patient underwent two procedures for aortic dissection, and 6 months after the second operation massive hemoptysis appeared abruptly. A false aneurysm rose from a graft-to-graft anastomotic site and ruptured into a segmental bronchus of the right upper lobe. Repair was performed without cardiopulmonary bypass.