ArticleInternational journal of surgery case reports2026
Double-layer repair of a tuberculous ascending aortic aneurysm: a case report and literature review.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and Importance: Tuberculous aneurysm of the ascending aorta is extremely rare and life-threatening, particularly in elderly patients. Early recognition and appropriate surgical management are essential to prevent fatal rupture. Case Presentation: An 84-year-old man presented with hemoptysis and chest tightness. Computed tomography revealed a saccular aneurysm of the ascending aorta with sternal erosion. During surgery, the aneurysm showed a caseous appearance with dense adhesions and infiltration into adjacent tissue. Frozen section demonstrated granulomatous inflammation suggesting tuberculous aortitis, which was later confirmed by postoperative Xpert MTB/RIF assay. A double-layer aortic repair was performed using an inner bovine pericardial patch and an outer Gelweave graft. The patient recovered well under antituberculous therapy and remained stable at 7-month follow-up. Clinical Discussion: Tuberculous aortitis in elderly patients is challenging due to degenerative aortic wall changes and hypertension. Intraoperative frozen section combined with gross findings played a key role in guiding the surgical strategy. The double-layer repair provided infection control and mechanical durability, consistent with current literature supporting biologic-synthetic hybrid reconstruction in infected aneurysms. Conclusion: A tuberculous aneurysm of the ascending aorta should be considered in atypical cases presenting with hemoptysis. In elderly patients with degenerative aortic walls and hypertension, double-layer repair offers effective infection control and durability when combined with appropriate antituberculous therapy. Early diagnosis and tailored surgical planning are crucial for favorable outcomes.
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