Rupture of Left Ventricular Outflow Tract Pseudoaneurysm Concomitant with Infectious Endocarditis

(Department of Cardiovascular Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan)

Akira Katayama Naomichi Uchida Kentaro Tamura
Miwa Sutoh Naoki Murao Masatsugu Kuraoka
An 82-year-old woman fell into a state of shock during the treatment for a urinary tract infection. Computed tomography and transthoracic echocardiography revealed massive pericardial effusion. Pericardiectomy was performed in the operating room and hemorrhagic effusion was observed. Emergent sternotomy was performed, and the bleeding site was located at the posterior portion of the left ventricular outflow. We diagnosed a rupture of a left ventricular outflow tract pseudoaneurysm after infectious endocarditis. A pericardium patch closure of the pseudoaneurysm and an aortic valve replacement were performed. The patient was discharged 35 days after the operation without recurrence of infection. Left ventricular outflow tract pseudoaneurysms is an uncommon complication following infective endocarditis, aortic valve surgery or chest trauma. Transesophageal echocardiography and multidetector-row computed tomography(MDCT)is useful for identifying such lesions.
  Jpn. J. Cardiovasc. Surg. 39:332-334(2010)

Keywords:infective endocarditis, left ventricular outflow tract pseudoaneurysm, cardiac tamponade