Int J Cardiovasc Imaging (2017) 33:749–750 DOI 10.1007/s10554-016-1051-5
CASE-IN-POINT
Pseudoaneurysm of the left ventricular outflow tract after cardiac surgery Marco Gennari1 · Andrea Annoni2 · Gianluca Polvani1
Received: 9 December 2016 / Accepted: 21 December 2016 / Published online: 4 January 2017 © Springer Science+Business Media Dordrecht 2017
Abstract Pseudoaneurysms of the left ventricular outflow tract (LVOT) are rare entity. We present a case of false aneurysm caused by a chronic bacterial infection after mechanical aortic valve replacement in otherwise healthy and asymptomatic young man. Keywords Pseudoaneurysm · Cardiac computed tomography · Cardiac imaging
Case presentation A pseudoaneurysm, also known as false aneurysm, is defined as a pathological wall dilatation not involving all the layers of a cavity or vessel and therefore at abrupt risk of rupture [1]. We present a case of a 39-year-old man with past medical history of aortic coartation and mechanical aortic valve replacement in 2013 for severe aortic insufficiency.
The annual follow-up echocardiogram revealed a 6 cm diameter aortic pseudoaneurysm. The thoracic computed tomography (CT) scan (Fig. 1) revealed a subvalvular pseudoaneurysm of the left ventricular outflow tract (Panel A. red arrow) below the mechanical prosthesis (green arrow). The course of the mass was evident below the non coronary—right coronary portion of the annulus (B. yellow arrow). The 3-dimensional reconstruction showed the anatomical shape of the pseudoaneurysm (C. orange arrow and the coartation, in violet arrow. D. Full cardiac reconstruction with the mass, blue arrow). The microbiological analysis of the operative sampling revealed an infection by a rare Staphylococcus lugdunensis. The postoperative course was uneventful and the patient discharged on prophylactic antibiotic therapy.
* Marco Gennari [email protected]; [email protected] 1
Department of Cardiovascular disease, Development Innovation Cardiac Surgery Unit, IRCCS Centro Cardiologico Monzino, Via Parea 4, 20138 Milan, Italy
2
Department of Cardiovascular Imaging, IRCCS Centro Cardiologico Monzino, Milan, Italy
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Vol.:(0123456789)
750
Int J Cardiovasc Imaging (2017) 33:749–750
Fig. 1 Computed tomography study
Compliance with ethical standards
Reference
Conflict of interest The authors declares that they have no conflict of interest.
1. Shariff MA, Martingano D, Khan U, Goyal N, et al. Left Ventricular Outflow Tract Pseudoaneurysm after Aortic Valve Replacement. Aorta. 2015;3(5):167–171
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CASE-IN-POINT
Pseudoaneurysm of the left ventricular outflow tract after cardiac surgery Marco Gennari1 · Andrea Annoni2 · Gianluca Polvani1
Received: 9 December 2016 / Accepted: 21 December 2016 / Published online: 4 January 2017 © Springer Science+Business Media Dordrecht 2017
Abstract Pseudoaneurysms of the left ventricular outflow tract (LVOT) are rare entity. We present a case of false aneurysm caused by a chronic bacterial infection after mechanical aortic valve replacement in otherwise healthy and asymptomatic young man. Keywords Pseudoaneurysm · Cardiac computed tomography · Cardiac imaging
Case presentation A pseudoaneurysm, also known as false aneurysm, is defined as a pathological wall dilatation not involving all the layers of a cavity or vessel and therefore at abrupt risk of rupture [1]. We present a case of a 39-year-old man with past medical history of aortic coartation and mechanical aortic valve replacement in 2013 for severe aortic insufficiency.
The annual follow-up echocardiogram revealed a 6 cm diameter aortic pseudoaneurysm. The thoracic computed tomography (CT) scan (Fig. 1) revealed a subvalvular pseudoaneurysm of the left ventricular outflow tract (Panel A. red arrow) below the mechanical prosthesis (green arrow). The course of the mass was evident below the non coronary—right coronary portion of the annulus (B. yellow arrow). The 3-dimensional reconstruction showed the anatomical shape of the pseudoaneurysm (C. orange arrow and the coartation, in violet arrow. D. Full cardiac reconstruction with the mass, blue arrow). The microbiological analysis of the operative sampling revealed an infection by a rare Staphylococcus lugdunensis. The postoperative course was uneventful and the patient discharged on prophylactic antibiotic therapy.
* Marco Gennari [email protected]; [email protected] 1
Department of Cardiovascular disease, Development Innovation Cardiac Surgery Unit, IRCCS Centro Cardiologico Monzino, Via Parea 4, 20138 Milan, Italy
2
Department of Cardiovascular Imaging, IRCCS Centro Cardiologico Monzino, Milan, Italy
13
Vol.:(0123456789)
750
Int J Cardiovasc Imaging (2017) 33:749–750
Fig. 1 Computed tomography study
Compliance with ethical standards
Reference
Conflict of interest The authors declares that they have no conflict of interest.
1. Shariff MA, Martingano D, Khan U, Goyal N, et al. Left Ventricular Outflow Tract Pseudoaneurysm after Aortic Valve Replacement. Aorta. 2015;3(5):167–171
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