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Case Reports
. 2011 Jul;4(2):195-9.
doi: 10.4103/0974-2069.84675.

Device occlusion of pseudoaneurysm of ascending aorta

Mridul Agarwal  1 , Mili Ray, M Pallavi, Supratim Sen, Debosree Ganguly, Pankaj Joshi, Sanjay Tanti, Amitabh Chattopadhyay, Biswajit Bandyopadhyay
Affiliations
Case Reports

Device occlusion of pseudoaneurysm of ascending aorta

Mridul Agarwal et al. Ann Pediatr Cardiol. 2011 Jul.

Abstract

Pseudoaneurysm of ascending aorta is an infrequent but well-recognized and potentially fatal complication after cardiac surgeries. The complication can develop early, delayed or late, and the presentation is also varied. We are presenting here two cases of pseudoaneurysm of ascending aorta following cardiac surgery that were successfully managed by the transcatheter method. The first one occurred following coronary artery bypass surgery and the second one occurred following double-valve replacement surgery. The aortic openings of these aneurysms were occluded with 12 mm and 10 mm atrial septal occluders, respectively, with a good outcome. An immediate postprocedure angiogram showed no residual flow into the sac. Six months of follow-up of both cases also showed excellent results.

Keywords: ASD occlude; Pseudoaneurysm; ascending aorta; device closure.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Transthoracic echo showing pseudoaneurysm arising from the ascending aorta
Figure 2
Figure 2
Three-dimensional reconstructed image showing trilobed pseudoaneurysm arising from the ascending aorta with a narrow neck (arrow head)
Figure 3
Figure 3
Cineangiogram showing (a) wire in position in the pseudoaneurysm sac, (b) hand injection in sac showing outline of central sac, (c) ASD Occluder in position at the mouth of the pseudoaneurysm and (d) aortic root injection after device release, showing no residual flow in the sac
Figure 4
Figure 4
Three-dimensional reconstruction of the computed tomography angiogram after device occlusion of the pseudoaneurysm; device can be seen in situ (arrow)
Figure 5
Figure 5
Computed tomography angiogram showing pseudoaneurysm (arrow) arising from the ascending aorta (AO)
Figure 6
Figure 6
Cineangiogram showing (a) neck of pseudoaneurysm engaged with right coronary artery catheter and hand injection showing pseudoaneurysm sac, (b) wire positioned within the sac, (c) ASD Occluder deployed at the neck of the pseudoaneurysm with delivery system and (d) aortic root injection after device placement showing no residual flow in the sac
Figure 7
Figure 7
Computed tomography (CT) angiogram showing the ASD device at the ascending aorta with no residual contrast to pseudoaneurysm sac documented in the preprocedure CT angiogram
See this image and copyright information in PMC

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