Evaluation of Perivalvular Infectious Ventricular Pseudoaneurysm by ECG-gated Cardiac Computed Tomography: 2 Case Reports

• Published in: Journal of thoracic imaging Vol. 27; no. 6; pp. W165 - W167
• Main Authors: Matsuo, Yuka, Kimura, Fumiko, Inoue, Kaiji, Ogawa, Harumi, Tabata, Mimiko, Uwabe, Kazuhiko, Nishi, Naoko, Komiyamam, Nobuyuki, Niinami, Hiroshi
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-11-2012
• Subjects: Adult; Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Aneurysm, False - surgery; Anti-Bacterial Agents - therapeutic use; Aortic Valve - diagnostic imaging; Contrast Media; Electrocardiography - methods; Endocarditis - complications; Endocarditis - drug therapy; Follow-Up Studies; Heart Ventricles - diagnostic imaging; Humans; Iopamidol; Male; Mitral Valve - diagnostic imaging; Multidetector Computed Tomography - methods; Radiographic Image Enhancement - methods; Tomography, Spiral Computed - methods; Treatment Outcome; Young Adult
• ISSN: 0883-5993; 1536-0237
• DOI: 10.1097/RTI.0b013e31822a250c

Left ventricular (LV) pseudoaneurysm is a serious complication of periannular extension of infective endocarditis (IE). Because pseudoaneurysm carries a high risk of rupture, its detection and evaluation are crucial for patient management and surgical planning. We report 2 cases with LV pseudoaneurysms, one near the aortic valve and the other near the mitral valve, which were caused by IE and treated successfully. In both cases, cardiac multidetector-row computed tomography enabled detection of the LV pseudoaneurysm and a detailed demonstration of its anatomic relationship with surrounding structures, which helped guide surgical planning.