Late sequela of aortotomy in infancy: supravalvular aortic stenosis and aneurysmal changes of epiaortic branches.

Figure 1: Preoperative computed tomography showed hourglass type of supravalvular aortic stenosis and aneurysmal changes of the innominate and the left subclavian artery. When she underwent ventricular septal defect repair at the age of 4 months, transverse aortotomy was made for evaluating a bicuspid aortic valve. Probably the transverse aortotomy was closed by a continuous suture, which, by definition, could not develop and grow with time, resulting in a tight aortic stenosis. Figure 2: Postoperative computed tomography after aortic root replacement with mechanical-valved conduit and total arch replacement with a fourbranched graft. The patient tolerated the procedure well and was discharged 2 weeks after surgery.