Case 22-1966

Presentation of Case First admission. A seventy-two-year-old man entered the hospital because of dyspnea.He had been well until nine years previously, when an aneurysm of the abdominal aorta was found in the course of a suprapubic prostatectomy. X-ray films of the chest showed minimal elongation of the thoracic portion of the aorta but were otherwise normal; an electrocardiogram was within normal limits. Several weeks later the aneurysm was resected, and an aortic homograft was inserted. Thereafter, he experienced mild exertional dyspnea, with little progression during the next few years. Three years before admission x-ray films of the chest . . .