CTICasesAortic Root Pseudoaneurysm and Paravalvular Leak
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
Chest radiograph shows a prosthetic aortic valve, epicardial pacing wires, and a dual-chamber pacemaker with disconnected leads. The thoracic aorta is elongated and slightly dilated, but radiography is otherwise unremarkable. Cardiac CT reveals a significantly dilated aortic root with a large, contrast-filled pseudoaneurysm communicating with the aortic root, and multiple areas of paravalvular leak around the prosthetic valve.
Key takeaways
Aortic root pseudoaneurysms and paravalvular leaks are serious, potentially life-threatening complications of aortic valve replacement, often associated with prior infective endocarditis. Because these lesions are located deep within the cardiac shadow, they are typically invisible on standard chest radiographs, necessitating cardiac CT or transesophageal echocardiography (TEE) for definitive diagnosis and surgical planning. This case highlights how such major vascular complications can go unrecognized until a patient undergoes cross-sectional imaging for another indication, such as a pacemaker pocket infection.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Extrapleural Chest Wall LipomaNeoplastic
- Excipient Lung Disease from Methylphenidate or OxyContin InjectionExposure
- Ritalin Lung (Talc-Induced Panlobular Emphysema)Exposure
- Acute Infectious Discitis and Epidural AbscessInfection
- Primary Pulmonary HemosiderosisOther
- King Supraglottic Airway DeviceArtifact
- Ectopic Parathyroid ParagangliomaNeoplastic
- SDH-Mutation Related Multicentric ParagangliomasNeoplastic
See all cases from February 13, 2015 →
Related Vascular cases
- Chronic Thromboembolic Pulmonary Hypertension (CTEPH) with Cavitary Pulmonary Infarctions
- Chronic Pulmonary Thromboembolism with Pulmonary Infarction and Cavitation
- Nodular Pulmonary Edema
- Saphenous Vein Graft Aneurysm
- Severe Pulmonary Arterial Hypertension with In Situ Thrombosis and Tortuous Vessels
- SVC and IVC Obstruction with Systemic-to-Pulmonary Venous Collaterals