A pulsatile chest mass after Bentall procedure: a case report

Aortic dissection is an aggressive and life-threatening cardiac disease with highly challenging in surgical operation. Bentall procedure was potential complications. How to manage them would be important to improve patient outcomes. In this case, we present a 41-year-old male patient with iatrogenic aortic dissection. He had aortic valve replacement and repair of atrial septal defect in 2012. After 5 years, he suffered reoperation for aortic dissection. A year later the patient was readmitted for a voluminous pulsatile mass over the anterior thorax, confirming the presence of a huge pseudoaneurysm originating from the left coronary bottom performed during the Bentall procedure, requiring a third operation to repair the hemorrhagic site. The pseudoaneurysm was common complication after inclusion technique in Bentall procedure. How to effective hemostasis or tension-free anastomosis was important to improve patient outcomes.