Left ventricular outflow tract pseudoaneurysm after aortic valve replacement: case report.
A 68-year-old woman was admitted for angina pectoris and general fatigue without symptoms or signs of infective endocarditis. The patient had undergone re-replacement of an aortic prosthetic valve three months previously. Transesophageal echocardiography revealed an echo-free cavity in the mitral-aortic intervalvular fibrosa region just below the aortic annulus, communication of the echo-free cavity with the left ventricular outflow tract, and turbulent flow into the cavity. Left ventriculography revealed a cavity that arose just below the aortic prosthetic valve, and which expanded in systole and collapsed in diastole. Coronary angiography showed significant stenosis of the proximal right coronary artery, but neither stenoses nor compression were found in the left coronary artery. Patch closure of the pseudoaneurysm and aortic root replacement using a Freestyle valve with reconstruction of the coronary arteries were successfully performed. Surgical trauma to the intervalvular fibrosa during removal of the original prosthetic valve may have caused pseudoaneurysm formation in this patient.
Aoyagi
Shigeaki
S
Department of Surgery, Kurume University School of Medicine, Kurume, Japan. aoyagi@med.kurume-u.ac.jp
Fukunaga
Shuji
S
Otsuka
Hiroyuki
H
Akaiwa
Kei-ichi
K
Yokokura
Yoshinori
Y
Yokokura
Hiroko
H
D000368:Aged; D017541:Aneurysm, False / Q000209:etiology*; D001021:Aortic Valve; D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D014694:Ventricular Outflow Obstruction / Q000209:etiology*