Pseudoaneurysm With Thrombus and Left Ventricular Inflow Obstruction After Left Circumflex Stenting

Abstract

A 61-year-old woman had stenting of the left circumflex coronary artery. She had a repeat coronary angiogram the day after stenting because of hypotension and orthopnea. The left circumflex stent was patent. A transesophageal echocardiogram showed a 2.5 cm x 3.0-cm mass in the atrioventricular groove compressing the left atrium. A pseudoaneurysm with thrombus and left ventricular inflow obstruction was diagnosed. The patient was observed for 48 hours to allow the pseudoaneurysm to seal and coagulate. She then had surgical evacuation of the thrombus, which had caused her hypotension and orthopnea by compression of the left atrium.

Chest Pain Due to Late Huge Coronary Pseudoaneurysm Following Stent Implantation

“…It is possible that the large pseudoaneurysm caused pleuritic pain. So after PCI each chest pain should be well evaluated, in fact pseudoaneurysm which developed after PCI have been associated with an adverse outcome when left untreated (7) because of catastrophic complications such as fissuration in the pericardium (8) or left ventricular inflow obstruction (9).…”