False Aortic Aneurysm Secondary to Chest Trauma
A 64-year-old woman with a history of coronary artery bypass graft surgery 2 years earlier presented with a bulging mass on the anterior chest wall 2 weeks after minor chest trauma. She denied having any symptoms, and her examination was remarkable only for a pulsatile mass in the left parasternal area of the anterior chest wall. Her ECG revealed sinus rhythm with nonspecific ST-T changes. Her chest radiograph showed marked cardiomegaly with a wide mediastinum. A transesophageal echocardiogram (TEE) was performed and confirmed the diagnosis of aortic pseudoaneurysm. A short-axis view of the aortic valve (A) is shown in Figure 1⇓. Intraoperative TEE with a rotational scanning acquisition was performed, and a 3-dimensional surface-rendered reconstruction was obtained.
Successive frames of the 3-dimensional echocardiographic reconstruction (Figure 2⇓) show the large para-aortic false aneurysm. The leakage site on the ascending aorta is clearly visible (white arrow). The mass with a different gray scale (black arrows) probably represents progressive aneurysm thrombosis.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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