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Ascending aortic pseudoaneurysm

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

Chest pain following recent aortic valve replacement procedure.

Patient Data

Age: 30 years
Gender: Male

Large retrosternal pseudoaneurysm (left anterolateral to the ascending aorta), it measures about 9.0 x 7.0 x 9.5 cm, it's surrounded by hypo density (thrombosis) that extends via the widened sternotomy sutures, it communicated via a narrow neck with ascending aorta with noticeable linear contrast extravasation. it compresses the ascending aorta posteriorly.

Bovine aortic arch (incidental finding).

Aortic valve prosthesis.

Annotated image

The aortic pseudoaneurysm (aneursym) is anterior to the ascending aorta (ASC),

Linear contrast extravasation from the ascending aorta into the pseudoaneurysm. "Red arrows"

Case Discussion

Ascending aortic pseudoaneurysm is a rare dangerous complication after cardiovascular surgery, trauma or infective aortitis.

They may remain asymptomatic and discovered later as incidental finding yet with potential fatal risk of rupture and severe hemorrhage. 

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