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Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shock
Seth M Maliske1, Laith Alshawabkeh2, Katie Schouweiler3
1Department of Internal Medicine, University of Iowa Hospital and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Journal of Cardiovascular Computed Tomography
|February 25, 2015
Summary
Aortic valve replacement patients with cardiogenic shock may have pseudoaneurysms. Coronary CT angiography aids in diagnosing coronary involvement, improving understanding of transesophageal echocardiography images for left ventricular dysfunction.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Surgery
Background:
- Endocarditis can necessitate aortic valve replacement.
- Post-operative complications following cardiac surgery require prompt diagnosis.
- Cardiogenic shock indicates severe cardiac dysfunction.
Observation:
- A 37-year-old male presented with cardiogenic shock post-aortic valve replacement.
- Multiple imaging modalities revealed a large, expansile pseudoaneurysm.
- Transesophageal echocardiography (TEE) is crucial for endocarditis diagnosis.
Findings:
- Coronary CT angiography (CCTA) proved feasible and provided good image quality for prosthetic valves.
- CCTA enhanced the interpretation of TEE images.
- CCTA facilitated earlier diagnosis of coronary involvement causing left ventricular dysfunction.
Implications:
- CCTA is a valuable tool for evaluating prosthetic valve complications.
- Integrated imaging approaches improve diagnostic accuracy in complex cardiac cases.
- Early identification of coronary involvement is critical for managing left ventricular dysfunction post-valve surgery.
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