Percutaneous closure of coronary ostial anastomoses pseudoaneurysm after Bentall

Abstract

Aortic pseudoaneurysm is a rare and serious complications after surgical aortic valve replacement. Its appearance in the reimplantation region of coronary arteries has been documented on very few occasions. This is the case of a 53-year-old man with a Stanford type A acute aortic dissection. The aortic root and ascending aorta were replaced with coronary artery reimplantation (modified Bentall-Bono technique) with favorable early disease progression. The thoracoabdominal computed tomography scan performed 25 days after surgery to study an incidental renal mass revealed the presence of a 14 mm x 10 mm hyperdense nodular image in the arterial phase of posterior location with respect to the left main coronary artery ostium consistent with a postoperative pseudoaneurysm (figure 1A,C, circle). A 3D transesophageal echocardiography confirmed the presence of a pseudoaneurysm surrounding the aortic root with flow inside stemming from the suture of the left main