False aneurysm due to suture loosening after aortic arch replacement

We describe a case of false aneurysm due to loosening of the anastomotic sutures 5 years after graft replacement for subacute type A aortic dissection. Leakage from the graft was controlled by tightening the suture slack indicating that suture loosening was the cause of the aneurysm. The mechanism was probably the progressive thinning of the edematous swollen aortic wall over the years causing the sutures to loosen.