TY - JOUR
T1 - Complete postsurgical left ventricular-aortic discontinuity and pseudoaneurysm formation
AU - Fu, Weibo
AU - Davari, Paran
AU - Issa, Mohamed
AU - Alslaim, Hossam
AU - Cortese, Nia
AU - Bates, William B.
AU - Ferraris, Victor
AU - Winkler, Michael Alan
N1 - Funding Information:
We wish to confirm that there has been no significant financial support for this study that could have influenced its outcome.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/7
Y1 - 2022/7
N2 - 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.
AB - 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.
KW - cardiac computed tomography
KW - left ventricular outflow tract
KW - left ventricular-aortic discontinuity
KW - pseudoaneurysm
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U2 - 10.1111/jocs.16553
DO - 10.1111/jocs.16553
M3 - Article
C2 - 35485714
AN - SCOPUS:85128961514
SN - 0886-0440
VL - 37
SP - 2155
EP - 2158
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 7
ER -