CTICasesAortic Root Pseudoaneurysm after Bioprosthetic Aortic Valve Replacement
Imaging findings
Gated CTA demonstrates a loculated outpouching below the aortic annulus at the mitral-aortic intervalvular fibrosa in a patient with a bioprosthetic aortic valve, questionable bacteremia, and organizing pneumonia. Multiplanar reformats show a thin potential tract between the subvalvular region and the outpouching, which has calcific densities along its undersurface and surrounding fluid.
Key takeaways
A subvalvular or perivalvular outpouching in the mitral-aortic intervalvular fibrosa (MAIVF) region should be considered a pseudoaneurysm, which is most commonly infective in etiology in the post-surgical setting. The radiologist should report it as a pseudoaneurysm and indicate the location rather than speculate on stability, as the surgical decision depends on clinical context.
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