Giant ascending aorta saccular aneurysm in a patient affected by Turner syndrome

Figure 1: A CT scan showing a huge saccular aneurysm of the ascending aorta (maximum axial diameter 14 × 12 cm) (A–C and H, white asterisks) with a wide neck on the left anterolateral wall (B, black asterisk). The pseudoaneurysm lumen was thrombus-filled (B–G, white arrows), with diffuse calcifications on the wall (C and E, red arrowheads). The aneurysm caused compression of the left main bronchus (D, red arrow) and the right pulmonary artery (RPA in B and D). The resulting dislocation of the aortic arch (AA in E–G), with severe reduction of its lumen (9 × 22 mm), particularly between the brachiocephalic trunk and left subclavian artery (BT and SA in G). Intraoperative findings confirmed the diagnosis (H). Surgery was performed after arterial and venous cannulation of femoral vessels and start of hypothermic extracorporeal circulation before chest opening. Surgical correction consisted in ascending aorta and hemiarch prosthetic replacement. RPA: right pulmonary artery; AA: aortic arch; BT: brachiocephalic trunk; SA: subclavian artery.