CTICasesAortic Root Endocarditis with Left Coronary Sinus Pseudoaneurysm
Imaging findings
CT angiography shows a pseudoaneurysm arising from the left coronary sinus of Valsalva with surrounding soft-tissue phlegmon posterior to the aortic root and communication with the left ventricle. Pathologic correlation confirmed Staph aureus endocarditis, treated with a pericardial patch and valve replacement.
Key takeaways
Aortic root endocarditis can lead to perivalvular extension of infection, resulting in abscess formation and pseudoaneurysm. The left coronary sinus and the mitral-aortic intervalvular fibrosa are highly susceptible due to their relative lack of vascularity, requiring surgical debridement and patch repair.
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