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Ann Thorac Surg 2004;77:2197-2199
© 2004 The Society of Thoracic Surgeons

Case report

Giant anastomotic pseudoaneurysm complicating aortic xenograft replacement

Nils Kucher, MDa, Beat Kipfer, MDb, Christian Seiler, MD, FACC, FESCa, Yves Allemann, MD, FESCa*

a Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
b Cardiovascular Surgery, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland

Accepted for publication June 6, 2003.

* Address reprint requests to Dr Allemann, Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010 Bern, Switzerland
e-mail: yves.allemann{at}insel.ch

A 74-year-old woman was referred for investigation of a 2-week history of progressive dyspnea. Her medical history included an aortic valve replacement with a stentless bioprosthesis followed 13 months later by the replacement of the aortic root with a porcine xenograft. Transesophageal echocardiography revealed a giant circular pseudoaneurysm of the aortic xenograft with compression of the prosthetic aortic valve and concomitant severe aortic regurgitation. Dehiscence of the proximal graft anastomosis was also diagnosed, and a possible distal anastomotic dehiscence was suspected. The latter turned out intraoperatively to be an almost complete dehiscence of the right coronary artery. The patient died intraoperatively.






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