CTICasesDelayed Aortic Graft Leak
Imaging findings
A follow-up chest CT, performed for pleural effusion evaluation post-heart transplant, demonstrates a new high-attenuation crescentic collection around a dacron ascending aortic graft. Non-contrast and subsequent angiographic CT scans confirm that this represents blood/hematoma confined to the graft segment, without active extravasation or significant surrounding mediastinal inflammation.
Key takeaways
Aortic graft anastomosis leaks can occur as a delayed complication post-surgery. They can be clinically silent, with patients remaining hemodynamically stable. The appearance of a high-attenuation fluid or hematoma collection closely wrapping the graft segment on CT represents a slow, contained leak or pseudoaneurysm that must be carefully distinguished from sterile perigraft fluid collections or mediastinitis.
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