Left Ventricular Outflow Pseudoaneurysm after Aortic Valve Replacement for Active Infective Endocarditis

(Department of Surgery, Yokohama City University, Yokohama, Japan)

Tomoki Choh Shinichi Suzuki Tomoyuki Minami
Hideyuki Iwaki Yukihisa Isomatsu Munetaka Masuda
A 56-year-old man, who underwent aortic valve replacement with a stentless artificial valve for aortic valve endocarditis at age 52, found to have left ventricular outflow pseudoaneurysm by transthorasic echocardiography, transesophageal echocardiography and enhanced computed tomography. We repaired the pseudoaneurysm, combined with valve re-replacement. Left ventricular outflow pseudoaneurysm is a rare disease, and is often associated with active endocarditis. Transesophageal echocardiography and CT scan are useful to diagnose this disease, especially to rule out annular abscess. Operative indication is recommended soon after the diagnosis was made to prevent rupture of pseudoaneurysm, or development of either mitral regurgitation or coronary ischemia due to compression from the pseudoaneurysm. Combined aortic valve replacement, with or without mitral valve replacement is necessary to repair the pseudoaneurysm.
  Jpn. J. Cardiovasc. Surg. 38:394-397(2009)

Keywords:infective endocarditis, aortic valve replacement, left ventricular outflow pseudoneurysm