Presentation of a pseudoaneurysm as a supravalvular aortic stenosis 20 years after aortic root reconstruction

A 36-year-old patient was referred because of fatigue and decreased exercise tolerance 20 years after separate aortic valve replacement and aortic root reconstruction. The presence of a loud systolic ejection murmur and persistent left ventricular hypertrophy led to the diagnosis of severe supravalvular aortic flow obstruction by indirect compression of a large pseudoaneurysm.