CTICasesAortic Root Pseudoaneurysms Complicating Endocarditis
Imaging findings
In a patient with a chronically thickened, heavily calcified aortic valve who presents with new fever and stroke, follow-up CT shows two new outpouchings arising from the aortic root: one along the posterior aspect of the root and a second, more inferior pseudoaneurysm that communicates directly with the left ventricle below the outflow tract, producing aortic regurgitation.
Key takeaways
New periaortic outpouchings developing over weeks in a febrile patient with a diseased valve should raise concern for endocarditis with pseudoaneurysm formation rather than simple post-stenotic dilation; a pseudoaneurysm communicating with the LV outflow tract requires combined valve and aortic root replacement.
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