Anastomotic Pseudoaneurysm after Aortic Root Replacement

Aortic root replacement has been an established standard procedure to treat annuloaortic ectasia (AAE) or aortic root aneurysm associated with significant aortic valvular disease. The long-term outcome after the surgery has also been favorably reported;however, an occurrence of anastomotic pseudoaneurysm remains a dreadful and serious complication. Detection of asymptomatic pseudoaneurysm used to be a challenge, because conventional computed tomography (CT) scan often fails to reveal a presence of pseudoaneurysm formation mainly due to remarkable artifact from prosthetic valve or motion effect. Recent advance in electrocardiogram (ECG)-gated 3-dimentional (3D)-CT has led to visualize even a small pseudoaneurysm and delineate an exact origin of a pseudoaneurysm. This powerful diagnostic modality enables us to precisely plan therapeutic strategy to accomplish efficacious surgical repair or interventional radiological treatment when possible.