CTICasesSinus of Valsalva pseudoaneurysm
Imaging findings
Cardiac MRI and MRA show a large, walled-off pseudoaneurysm arising from the left aortic sinus of Valsalva, with intense peripheral delayed enhancement and internal slow-flowing blood mimicking a thrombus, causing compression of the ramus intermedius artery and myocardial infarction.
Key takeaways
Sinus of Valsalva pseudoaneurysms can occur as a late mechanical complication of aortic valve interventions such as balloon valvuloplasty. They can compress adjacent coronary artery branches, leading to myocardial ischemia or infarction, and can be mistaken for left atrial thrombus on cardiac MRI.
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