CTICasesLeft Ventricular Outflow Tract Pseudoaneurysm Secondary to Endocarditis
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Imaging findings
ECG-gated cardiac CT shows a focal defect in the myocardium of the left ventricular outflow tract (LVOT) communicating via a narrow neck with a large, walled-off, fluid-filled pseudoaneurysm. There is also a suspected small secondary communication or tract adjacent to the aortic valve annulus, likely representing a healed paravalvular abscess tract.
Key takeaways
Myocardial pseudoaneurysms of the left ventricle are usually complications of myocardial infarction or cardiac surgery. However, they can also occur as a late sequela of infective endocarditis with paravalvular abscess formation that erodes through the subendocardial layer and myocardium, necessitating surgical repair with patch closure.
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