Case Description
A 52-year-old gentleman, with several cardiovascular risk factors was
referred for surgical management; other history was notable for end
stage renal disease with a left upper limb fistula, severe peripheral
vascular disease, and Protein C deficiency resulting in recurrent deep
vein thrombosis requiring a greenfield filter. He had undergone coronary
artery bypass grafting five months prior with LIMA-LAD, and saphenous
vein grafts to posterior descending artery and ramus intermedius
complicated by left arm ischemia requiring angioplasty. He had
re-presented at an interval with progressive dizziness, fatigue, and
lightheadedness. Computed tomography (CT) imaging revealed an aortic
pseudoaneurysm at the original aortic cannulation site with an ostium of
9 x 7 mm that was compressing 50% of the main pulmonary artery (figure
1A).