A fifty-five-year-old man presented with pseudoaneurysm five years after composite aortic graft replacement for aortic dissection. The transthoracic echocardiogram appeared to show a right atrial mass. Transesophageal echocardiography and magnetic resonance imaging correctly delineated the pseudoaneurysm. Cardiac catheterization and superior vena cavagraphy were confirmatory The diagnostic features and natural history of this complication are discussed.
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References
1.
Kouchoukos NT , Marshall WG Jr, Wedige-Stecher TA: Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve. J Thorac Cardiovasc Surg92:691-705, 1986.
2.
Taniguchi K. , Nakano S., Matsuda H., et al: Long-term survival and complications after composite graft replacement for ascending aortic aneurysm associated with aortic regurgitation. Circulation84:III-31-III-39, 1991.
3.
Kong B., Ogilby JD, Poynton R.: Pseudoaneurysm of a Shiley composite aortic valve and graft prosthesis. Am Heart J120:1002-1004, 1990.
4.
Nair KK: False aneurysm of the ascending aorta after surgery for Marfan's syndrome . J Thorac Cardiovasc Surg71:765-767, 1976.
5.
McFalls EO, Palac R., Gately H., et al: Pseudoaneurysm formation with superior vena caval syndrome seven years after aortic graft placement. Ann Thorac Surg48:704705, 1989.
6.
Mautner SL, Mautner GC, Curry CL, et al: Massive perigraft aortic aneurysm late after composite graft replacement of the ascending aorta and aortic valve in the Marfan syndrome . Am J Cardiol71:624-627, 1993.
7.
Barbetseas J. , Crawford S., Safi HJ, et al: Doppler echocardiographic evaluation of pseudoaneurysms complicating composite grafts of the ascending aorta. Circulation85:212-222, 1992.
8.
Lasorda DM, Power TP, Dianzumba SB, et al: Diagnosis of aortic pseudoaneurysm by echocardiography. Clin Cardiol15:773-776, 1992.
9.
Mohan JC, Reddy KN, Khanna SK, et al: Pseudoaneurysm of the ascending aorta complicating cardiac surgery: Role of echocardiography in the diagnosis. Int J Cardiol31:33-37, 1991.
10.
Ertzner T., Powers T.: Pseudoaneurysm detection with Tc-99m-labeled red blood cells. Radiology154:507-512, 1985.
11.
Akins EW, Limacher M., Slone RM, et al: Evaluation of an aortic annular pseudoaneurysm by MRI: Comparison with echocardiography, angiography and surgery. Cardiovasc Intervent Radiol10: 188-193,1987.
12.
Seward JB, Khandheria BK, Oh JK, et al: Transesophageal echocardiography: Technique, anatomic correlations, implementation, and clinical applications. Mayo Clin Proc63:649-680, 1988.
13.
Seward JB, Khandheria BK, Edwards WD, et al: Biplane transesophageal echocardiography: Anatomic correlations, image orientation, and clinical applications. Mayo Clin Proc65:1193-1213, 1990.
14.
Barakos JA, Brown JJ, Higgins CB: Magnetic resonance imaging of secondary cardiac and paracardiac masses. AJR153:48, 1989.
15.
Helseth HK, Haglin JJ, Monson BK, et al: Results of composite graft replacement for aortic root aneurysms . J Thorac Cardiovasc Surg80:754-759, 1980.
16.
McDonald GR , Schaff HV, Pyeritz RE, et al: Surgical management of patients with Marfan's syndrome and dilatation of the ascending aorta. J Thorac Cardiovasc Surg81:180-186, 1981.
17.
Danaldson RM , Ross DN: Composite graft replacement for the treatment of aneurysms of the ascending aorta associated with aortic valvular disease . Circulation66:I-116-I-121, 1982 .
