Complete postsurgical left ventricular-aortic discontinuity and pseudoaneurysm formation

Weibo Fu, Paran Davari, Mohamed Issa, Hossam Alslaim, Nia Cortese, William B. Bates, Victor Ferraris, Michael Alan Winkler

Research output: Contribution to journalArticlepeer-review


Background: Left ventricular outflow tract pseudoaneurysm is a rare but potentially fatal complication of aortic valve replacement, infective endocarditis (IE), and suture dehiscence. Left ventricular-aortic discontinuity is a severe and uncommon manifestation of IE. For patients who have a long-standing history of endocarditis, periannular lesions in the aortic valve may rupture, leading to the rare occurrence of complete, or total, left ventricular-aortic discontinuity. Methods: We present a case of complete postoperative left ventricular-aortic discontinuity and massive circumferential left ventricular outflow tract pseudoaneurysm discovered during a 3-month follow-up visit. Appropriate consent was obtained from all parties before submission of this case report. Results: Postoperative cardiac computed tomography of a patient demonstrated dehiscence of a recently placed surgical aortic valve from the left ventricular outflow tract, with massive circumferential pseudoaneurysm formation. Only a small remnant of the membranous interventricular septum connected the aortic root to the heart, informing the diagnosis of complete left ventricular-aortic discontinuity. Conclusion: The clinical presentation of a left ventricular outflow tract pseudoaneurysm with concomitant left ventricular-aortic discontinuity is commonly nonspecific or clinically silent; thus, it requires a high index of suspicion and use of multimodality imaging for diagnosis and management.

Original languageEnglish (US)
Pages (from-to)2155-2158
Number of pages4
JournalJournal of Cardiac Surgery
Issue number7
StatePublished - Jul 2022


  • cardiac computed tomography
  • left ventricular outflow tract
  • left ventricular-aortic discontinuity
  • pseudoaneurysm

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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