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.