Abstract
Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.
Similar content being viewed by others
References
Bizzarri F, Braconi L, Rossi A, Sorbara C, Stefano PL (2005) Left ventricular outflow tract false aneurysm late after aortic valve replacement. Heart Surg Forum 8(3):E136–E139
Gupta R, Jammula P, Huang MH, Atar S, Ahmad M (2006) An unusual complication after aortic valve replacement. J Clin Ultrasound 34(7):361–364
Pongratz G, Pohlmann M, Gehling G, Bachmann K (1997) Pseudoaneurysm in the intervalvular mitral-aortic region after endocarditis and prosthetic aortic valve replacement. Circulation 96:3241–3242
Aoyagi S, Fukunaga S, Otsuka H, Akaiwa K, Yokokura Y, Yokokura H (2004) Left ventricular outflow tract pseudoaneurysm after aortic valve replacement: case report. J Heart Valve Dis 13(1):145–148
Afridi I, Apostolidou MA, Saad RM, Zoghbi WA (1995) Pseudoaneurysm of the mitral-aortic intervalvular fibrosa: dynamic characterization using transesophageal echocardiographic and doppler techniques. J Am Coll Cardiol 25:137–145
Borman JB, Hellman-Hakohaen A, Weiss AT (1982) Sub-valvular pseudo-aneurysm after aortic valve replacement. A case report. Scand J Thorac Cardiovasc Surg 16(2):125–127
Jaggers J, Fullerton DA, Campbell DN, Clarke DR (1996) LVOT pseudoaneurysm: a late complication of extended aortic root replacement. Ann Thorac Surg 62(4):1198–1199
Espinosa-Caliani JS, Montijano A, Melero JM, Montiel A (2000) Pseudoaneurysm in the mitral-aortic intervalvular fibrosa. A cause of mitral regurgitation. Eur J Cardiothorac Surg 17(6):757–759
Ghersin E, Litmanovich D, Agmon Y, Milo S (2005) Pseudoaneurysm of the mitral-aortic intervalvular fibrosa following aortic valve replacement-dignosis and dynamic evaluation with multidetector CT and transesophageal echocardiography. Interact CardioVasc Thorac Surg 4:502–504
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Da Col, U., Ramoni, E., Di Bella, I. et al. An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair. Cardiovasc Intervent Radiol 32, 188–191 (2009). https://doi.org/10.1007/s00270-008-9406-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-008-9406-5