Ascending aortic true aneurysm after acute aortic dissection in a patient with systemic lupus erythematosus

A 50-year-old woman presented to our hospital with shortness of breath on exertion and nocturnal dyspnea. She had undergone total aortic arch replacement for Stanford type A aortic dissection 17 years previously and was taking prednisolone for systemic lupus erythematosus. Computed tomography showed that the 63-mm ascending aorta near the proximal anastomosis site compressed the superior vena cava and right atrium. Cardiac catheterization showed occlusion of the left anterior descending branch. The patient underwent urgent surgery for ascending aortic aneurysm and coronary artery occlusion. Microscopic examination revealed that the aneurysm was true. This report highlights that in patients with systemic lupus erythematosus, aortic aneurysms can reoccur even after total arch replacement.