Second Redo for Composite Graft Pseudoaneurysm with Transcutaneous Rupture.

Six months after a composite graft redo operation repairing two pseudoaneurysms at the distal suture line and the right coronary artery, respectively, a patient returned asymptomatic and in good general condition but with new presternal bulges. Computed tomography and angiography diagnosed a new pseudoaneurysm of the left coronary artery, and on frank rupture, acute re-repair was undertaken with the aid of presternotomy hypothermic circulatory arrest. Temporary postoperative neurological dysfunction subsided and recovery was otherwise uneventful.