A 34-year-old female patient, who had undergone several operations relating to pulmonary atresia with ventricular septal defect (PA/VAD), was admitted to our hospital for recurrent massive hemoptysis requiring blood transfusion. She had undergone a Potts' shunt (systemic-pulmonary shunt) at age 3, and undergone intraaortic patch closure for paraanastomotic pseudoaneurysm of occluded Potts' shunt at age 28. Chest CT scan revealed an enhancement of this aneurysm surrounding ground glass like appearance of left lung lobe which indicated pulmonary bleeding. In order to avoid skeltonization of severe adhesion of mediastinal and left thoracic space due to several prior operations, endovascular repair of this pseudoaneurysm with debranching of left subclavian artery was performed. Postoperative course was uneventful and hemoptysis was disappeared. She was discharged at 8 postoperative day.

A 71-year-old man had undergone branched open stent grafting for a distal arch aneurysm in May 2006. He subsequently developed multiple episodes of postoperative endoleak successfully treated by TEVAR in January and November 2009. He visited our hospital complaining of back pain in May 2011. Chest computed tomography showed increasing size of the aneurysm and recurrent endoleak of the distal stent graft, and impending rupture of the aneurysm was diagnosed. Considering the technical difficulty of repair by TEVAR, we performed graft replacement of the aneurysm with removal of the previous stent graft. The postoperative course was unremarkable and he was discharged on postoperative day 11.