A 50-year-old male was found to have a 27-mm sac-cular aneurysm of the ascending aorta nine months following orthotopic heart transplantation for dilated-phase hypertrophic cardiomyopathy (Fig. 1). The patient was placed on femoral arterial-venous bypass and the patient's chest was entered through a right anterolateral thoracotomy over the 4th intercostal space. The aneurysm was at the suture line between the donor and recipient aorta (Fig. 2A). Under a period of cardioplegic arrest, the aneurysmal wall was excised (Fig. 2B) and the defect was closed with a prosthetic Dacron patch. The postoperative course was complicated by prolonged respiratory failure and the need for a tracheostomy. He has since recovered and is doing well 15 months following surgery.
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