A rare case of an expanded perigraft seroma with heart failure after thoracic aortic surgery.

Perigraft seroma (PS) is an occasional complication of abdominal and femoral aortic graft implantation. We report a rare case with heart failure due to expanded PS compressing the right atrium 5 years after ascending aorta replacement for an acute type A aortic dissection. The PS was drained and sealed with biological tissue adhesive and wrapped using bovine xenopericardial sheet. We believe that mild hemorrhage through a vascular graft caused the expanded PS. Furthermore, wrapping vascular grafts using bovine xenopericardial sheet after sealing with biological tissue adhesive was effective for PS, particularly in cases in which it is impossible to use greater omentum. Learning objective: Cases of perigraft seroma (PS) after thoracic aortic repair have rarely been reported. The mechanism, indications, and treatments are unclear. We report a case of heart failure caused by expanded PS due to a small hemorrhage through a vascular graft. Furthermore, wrapping vascular grafts using bovine xenopericardial sheet after sealing with biological tissue adhesive may be effective for PS, particularly in cases where it is impossible to use the greater omentum.