Author + information
- Received June 26, 2012
- Revision received September 6, 2012
- Accepted September 12, 2012
- Published online April 1, 2013.
- Salwa M. Gendi, MD⁎ (, )
- Damien Kenny, MD,
- John Hibbeln, MD and
- Ziyad M. Hijazi, MD, MPH
- ↵⁎Reprint requests and correspondence:
Dr. Salwa Gendi, Rush Center for Congenital and Structural Heart Disease, Rush University Hospital, Suite 770 Jones, 1653 West Congress Parkway, Chicago, Illinois 60612
A 75-year-old man presented with worsening right heart failure on the background of previous supracoronary ascending aortic replacement and bioprosthetic aortic valve replacement for bicuspid aortopathy. Transthoracic echocardiography demonstrated continuous flow on color Doppler from an ascending aortic aneurysm fistulating into the right atrium (Fig. 1A). Noncontrast magnetic resonance imaging confirmed a large pseudoaneurysm of the proximal ascending aorta around the graft and fistulous connection into the right atrium (Fig. 1B). On intra-procedural angiography, the neck of the pseudoaneurysm was revealed at the anastomosis point of the aortic graft to the true ascending aorta (Fig. 2). Closure of the fistula between the pseudoaneurysm and the right atrium was achieved with a 12-mm Amplatzer Muscular Occluder (St. Jude Medical, St. Paul, Minnesota). Subsequently, the neck of the pseudoaneurysm was occluded with a 14-mm Amplatzer Vascular Plug II. There was no residual flow into the pseudoaneurysm or fistula seen with angiography. Post-procedural transthoracic echocardiography demonstrated no residual flow across the pseudoaneurysm (Fig. 3).
The authors thank Dr. Q. Cao for help with images.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 26, 2012.
- Revision received September 6, 2012.
- Accepted September 12, 2012.
- American College of Cardiology Foundation