Thoracic Aortic Aneurysm 40 Years After Tube Graft Repair

Figure

a) Enlarged left upper mediastinum on chest X-ray; b) Volume reconstruction of the chest CT showing the aneurysm cranial to the tube graft

An over 50-year-old female patient had undergone surgery as a teenager for coarctation of the aorta involving insertion of a 14-mm Gore-Tex tube graft between the distal aortic arch and the descending aorta. She had not been under medical care since turning 22, nor was she aware of what she had been operated for. She presented with unspecific symptoms and arterial hypertension of 155/65 mm Hg, with no pressure gradient between the upper and lower extremities. Chest X-ray showed marked enlargement of the left upper mediastinum. Computed tomography confirmed the suspicion of thoracic aortic aneurysm. During re-operation, the subclavian artery was re-implanted in the left carotid artery, the tube graft was excised, and a new 22-mm tube graft was inserted. The patient was able to leave the hospital after 37 days in good general condition. Patients with congenital heart defects should remain lifelong under the care of cardiologists with expertise in the treatment of “adults with congenital heart defects.”

Acknowledgments: Our thanks go to PD Dr. Dr. Christian Meierhofer, Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, TUM Universitätsklinikum.

Prof. Dr. med. Julie Cleuziou, cand. med. Julia Hoffmann, Dr. med. Maria von Stumm, Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie, Deutsches Herzzentrum München, TUM Universitätsklinikum, [e-mail]

Conflict of interest statement: The remaining authors declare that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Cleuziou J, Hoffmann J, von Stumm M: Thoracic aortic aneurysm 40 years after tube graft repair. Dtsch Arztel Int 2025; 122: 81. DOI: 10.3238/arztebl.m2024.0216