Ascending aortic pseudoaneurysm is a rare but life-threatening complication after cardiac surgery, typically requiring redo open repair with substantial risk. We report a 58-year-old male with an incidental 85-mm ascending pseudoaneurysm discovered during evaluation for recurrent hepatocellular carcinoma. Due to prior sternotomy, cirrhosis, and urgent oncologic need, open surgery was deemed prohibitive. He successfully underwent thoracic endovascular repair with reverse extra-anatomical aortic arch debranching technique. He recovered uneventfully and proceeded to cancer treatment without delay. This case highlights the feasibility of hybrid endovascular strategies for ascending aortic pathology in high-risk patients.
Tada et al. (Thu,) studied this question.