Pseudoaneurysm Complicating Anterior Arch of Congenital Double Aortic Arch

Aortic rupture and pseudoaneurysm formation in the anterior arch of congenital double aortic arch anomaly associated with a coarctation is an exceedingly rare complication of aortic vascular ring. This is a case report of a double aortic arch with an anterior arch pseudoaneurysm, presenting with chest pain, respiratory distress, and hypotension. The patient underwent open-heart surgery with resection of the anterior arch pseudoaneurysm and bypassing of the coarctation with ascending aorta to descending aorta connection with a Dacron tube graft. Posterior aortic arch entering to pseudoaneurysm by a vertical artery also connected to the main Dacron tube by another small size of the Dacron tube. The postoperative course was complicated by chylothorax and respiratory distress that managed with prolonged preservation of chest tubes, chest physiotherapy, and low lipid content diet. One year follow-up with C_T angiography revealed the patency of both the Dacron tube and patient was in good condition.