Postoperative aortic root pseudoaneurysm

Case contributed by Andrea Molinari
Diagnosis almost certain

Presentation

A patient who has undergone prosthetic aortic valve replacement performed transesophageal echocardiography with the finding of a perivalvular fluid collection.

Patient Data

Age: 80 years
Gender: Male

ECG-gated cardiac CT

ct

The post contrast Cardiac CT shows a hyperdense oval image consistent with pseudoaneurysm (3x2x4cm LLxAPxCC) lying posterior to the aortic root and with narrow neck at the junction between the left ventricular outflow tract (LVOT) and the prosthetic aortic valve.

Bilateral pleural effusion.

Case Discussion

The occurrence of graft dehiscence as complication at the site of the anastomosis after AVR (aortic valve replacement) can result in the development of a pseudoaneurysm 1.

This complication is rare, but must be urgently referred for cardiac surgery consultation given the high risk of rupture 1.

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