Pseudoaneurysm in the Left Ventricular Outflow Tract after Prosthetic Aortic Valve Implantation Evaluation upon Multidetector-Row Computed Tomography

The high accuracy of multidetector-row computed tomography (MDCT) in evaluating prosthetic valve disorders has been confirmed. This, we believe, is the 1st report of the use of MDCT to detect and evaluate left ventricular outflow tract (LVOT) pseudoaneurysms in patients who have undergone aortic valve replacement with prosthetic valves. We used MDCT to scan 21 such patients, 3 of whom had a small pseudoaneurysm in the LVOT Each pseudoaneurysm projected away from the LVOT and had a narrow neck that was located just below the sewing ring of the prosthetic aortic valve. One pseudoaneurysm was not thrombotic, I was partially thrombotic, and I was completely thrombotic. One of these had gone undetected earlier on transthoracic echocardiography. We consider MDCT to be superior to echocardiography in the detection of LVOT pseudoaneurysms in patients who have undergone aortic valve replacement with prosthetic valves. We publicize our results in the hope that larger studies will be undertaken in order to investigate the prevalence and clinical implications of our findings. (Tex Heart Inst J 2009:36(5):428-32)