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Complete Postsurgical Left Ventricular-Aortic Discontinuity and Pseudoaneurysm Formation
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  • Weibo Fu,
  • Paran Davari,
  • Hossam Alslaim,
  • Niayesh Cortese,
  • Mohamed Issa,
  • William Bates,
  • Victor Ferraris,
  • Michael Winkler
Weibo Fu
Medical College of Georgia

Corresponding Author:webzfu@gmail.com

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Paran Davari
University of California San Francisco School of Medicine
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Hossam Alslaim
Medical College of Georgia
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Niayesh Cortese
Medical College of Georgia
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Mohamed Issa
University of Kentucky Medical Center
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William Bates
Augusta University Medical College of Georgia
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Victor Ferraris
University of Kentucky Medical Center
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Michael Winkler
Augusta University Medical College of Georgia
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Abstract

Background: Left ventricular outflow tract pseudoaneurysm is a rare but potentially fatal complication of aortic valve replacement, infective endocarditis, and suture dehiscence. Left ventricular-aortic discontinuity is a severe and uncommon manifestation of IE. For patients who have a long-standing history of endocarditis, peri-annular lesions in the aortic valve may rupture, leading to the rare occurrence of complete, or total, left ventricular-aortic discontinuity. Methods: We present a case of complete postoperative left ventricular-aortic discontinuity and massive circumferential left ventricular outflow tract pseudoaneurysm discovered during a 3-month follow-up visit. Results: Post-operative cardiac CT of a patient demonstrated dehiscence of a recently placed surgical aortic valve from the left ventricular outflow tract, with massive circumferential pseudoaneurysm formation. Only a small remnant of the membranous interventricular septum connected the aortic root to the heart, informing the diagnosis of complete left ventricular-aortic discontinuity. Conclusion: The clinical presentation of a left ventricular outflow tract pseudoaneurysm with concomitant left ventricular-aortic discontinuity is commonly nonspecific or clinically silent; thus, it requires a high index of suspicion and use of multimodality imaging for diagnosis and management.
17 Sep 2021Submitted to Journal of Cardiac Surgery
17 Jan 2022Submission Checks Completed
17 Jan 2022Assigned to Editor
18 Jan 2022Reviewer(s) Assigned
20 Jan 2022Review(s) Completed, Editorial Evaluation Pending
20 Jan 2022Editorial Decision: Revise Major
08 Mar 20221st Revision Received
08 Mar 2022Submission Checks Completed
08 Mar 2022Assigned to Editor
08 Mar 2022Reviewer(s) Assigned
15 Mar 2022Review(s) Completed, Editorial Evaluation Pending
15 Mar 2022Editorial Decision: Revise Minor
29 Mar 20222nd Revision Received
29 Mar 2022Submission Checks Completed
29 Mar 2022Assigned to Editor
29 Mar 2022Reviewer(s) Assigned
02 Apr 2022Review(s) Completed, Editorial Evaluation Pending
03 Apr 2022Editorial Decision: Accept
Jul 2022Published in Journal of Cardiac Surgery volume 37 issue 7 on pages 2155-2158. 10.1111/jocs.16553