Pseudoaneurysm Formation of the Ascending Aorta

A 50-years-old male patient, hypertensive, on renal dialysis and with secondary hyperparathyroidism, underwent aortic valve replacement with a #23 mm Sorin bileaflet mechanical prosthesis. Three months later he had a redo operation to fix a perivalvular leak. There was no evidence of infection. A year later he was referred to us with an asymptomatic paraortic mass in a CT Thorax. Further investigation with CT angiogram (Figure 1A) and aortogram (Figure 1B) revealed a 5.5 × 4.8 cm mass in close proximity to the middle and lateral aspect of the ascending aorta, filling with contrast fluid. During the third operation, a pseudoaneurysm formation was confirmed (Figure 2A). Resection of the wall of the sac revealed a dehiscence 4 × 4 mm at the lateral angle of the previous aortotomy (Figure 2B) due to broken 4/0 prolene stich. The dehiscence was repaired with two 2/0 pledgeted ethibond stiches. Uncomplicated recovery. No evidence of recurrence 12 months following surgery.

Conflict of Interest

The Authors declare that there is no conflict of interest.