Giant left ventricular pseudoaneurysm.
Left ventricular (LV) pseudoaneurysm (PS) is an uncommon, often fatal complication associated with myocardial infarction, cardiothoracic surgery, trauma, and, rarely, infective endocarditis. A 28-year-old man with prior history of bioprosthetic mitral valve replacement presented with congestive heart failure and bacteremia with Abiotrophia granulitica. Transesophageal echocardiogram showed bioprosthesis dysfunction, large vegetations, mitral regurgitation, and probable PS. Cardiac and chest CT confirmed a PS communicating with the left ventricle Patient had pulseless electrical activity and died. Autopsy showed a giant PS with layered thrombus and pseudo-endothelialized cavity. Our case highlights the importance of multimodality imaging as an important tool in management of PS.
Prakash
Sumi
S
Department of Internal Medicine, University Hospital and Clinics, Columbia, MO 65212, USA. prakashsu@health.missouri.edu
Garg
Nadish
N
Xie
Gong-Yuan
GY
Dellsperger
Kevin C
KC
D000328:Adult; D056567:Aerococcaceae / Q000302:isolation & purification; D017541:Aneurysm, False / Q000175:diagnosis* / Q000209:etiology; D001344:Autopsy; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000209:etiology / Q000382:microbiology; D017809:Fatal Outcome; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D015819:Substance Abuse, Intravenous / Q000150:complications; D014057:Tomography, X-Ray Computed