Left Ventricular Outflow Tract False Aneurysm Late after Aortic Valve Replacement

Abstract

We describe an unusual case of left ventricular outflow tract (LVOT) pseudoaneurysm late after aortic valve replacement. A 77-year-old man, who had undergone aortic valve replacement with mechanical prosthesis 7 years ago, presented, asymptomatic, with a transesophageal echocardiography (TTE) diagnosis of a large cavitary mass arising behind the aortic wall. The orifice of the pseudoaneurysm was successfully surgically closed and the aortic root reconstructed with cryopreserved homograft.

Subaortic aneurysm after arterial switch operation for transposition type double outlet right ventricle

“…LVOT aneurysm is a rare complication of aortic valve replacement, endocarditis, or chest trauma surgery. 1 , 2 , 3 It has been reported as a pseudoaneurysm that is usually found in the mitral-aortic intervalvular fibrosa. 1 , 2 , 3 , 4 Our patient had undergone an arterial switch operation with coronary transfer as an infant; however, the subaortic LVOT, including the mitral-side ventriculo-infundibular fold, had not been corrected during that operation.…”

“…Left ventricular outflow tract (LVOT) aneurysm is rare and has been reported in association with postcardiac surgery trauma or infective endocarditis. 1 , 2 , 3 We have reported a case of asymptomatic LVOT aneurysm of the ventricular infundibular fold (VIF) that had been present between the aortomitral annulus, which exists only in the presence of a double outlet right ventricle (DORV). The aneurysm had been detected after complete repair of transposition of the great arteries (TGA) and DORV.…”

Cardiac Tamponade due to Left Ventricular Pseudoaneurysm After Aortic Valve Replacement

“…The natural course of LVOT pseudoaneurysm is unclear. It is considered potentially fatal because of the risk of rupture into the pericardium, with the consequent cardiac tamponade, compression of the adjacent left main coronary artery, and mitral valve compression with severe regurgitation [Afridi 1995;Bizzarri 2005;Gupta 2006]. Therefore, prompt surgical resection is standard.…”

“…Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly occurring with aortic root endocarditis, surgery, chest trauma, or congenital heart disease. Usually, it originates from a dehiscence in the mitral-aortic intervalvular fibrosa that arises posteriorly to the aortic root [Pongratz 1007;Bizzarri 2005;Gupta 2006]. Owing to these anatomic features, its assessment via imaging methods is challenging, and surgical repair requires complex procedures.…”