Aortic coarctation (CoAo) accounts for 6 to 8% of all congenital heart diseases and occurs two to five times more often in males. The uncorrected aortic coarctation is complicated by hypertension, ascending and descending aortic aneurysms, endarteritis, and heart failure. The aortic pseudo-aneurysm (APD) usually occurs in patients with endarteritis. We report an adult man with bicuspid aortic valve, perimembranous ventricular septal defect, and uncorrected aortic coarctation complicated by descending aortic pseudo-aneurysm without aortic endarteritis. A 40-year-old man was referred to our division for hemoptysis and severe aortic coarctation. Echocardiography confirmed the aortic coarctation diagnosis and showed a large aortic pseudo-aneurysm at the coarctation site with intra-cavity mural thrombus. Subsequently, the patient underwent contrast-enhanced computed tomography angiography, and diagnosis of coarctation and APD was confirmed. Due to various malformations and considering that the patient had become unstable due to hemoptysis, it was discussed in the heart team, and it was decided that the patient would undergo staged surgery. The aortic pseudo-aneurysm is a rare complication in patients with untreated coarctation that requires prompt surgery, and this complication should be considered in patients with untreated aortic coarctation who present with hemoptysis.

中文翻译：

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未矫正主动脉缩窄成年男性的巨大降主动脉假性动脉瘤

主动脉缩窄 (CoAo) 占所有先天性心脏病的 6% 至 8%，在男性中的发生率是男性的 2 至 5 倍。未矫正的主动脉缩窄并发高血压、升主动脉和降主动脉瘤、动脉内膜炎和心力衰竭。主动脉假性动脉瘤（APD）通常发生在动脉内膜炎患者身上。我们报告了一名成年男性，患有二叶主动脉瓣、膜周室间隔缺损和未矫正的主动脉缩窄并发降主动脉假性动脉瘤，但没有主动脉内膜炎。一名 40 岁男性因咯血和严重主动脉缩窄被转诊至我们科。超声心动图证实了主动脉缩窄的诊断，并显示缩窄部位有一个大的主动脉假性动脉瘤，并伴有腔内壁血栓。随后，该患者接受了对比增强计算机断层扫描血管造影术，并确认了缩窄和 APD 的诊断。由于各种畸形，考虑到患者因咯血而变得不稳定，经心脏组讨论，决定对患者进行分期手术。主动脉假性动脉瘤是未经治疗的缩窄患者的罕见并发症，需要及时手术治疗，未经治疗的主动脉缩窄患者出现咯血时应考虑这种并发症。