Ascending Aortic Pseudoaneurysm: Sleeping Giant Arises in 3rd Decade after Surgery

Transthoracic echocardiogram (parasternal long-axis view) shows a large pseudoaneurysm (PsA) arising from the aorta and lined by intramural thrombus (arrowheads). The pseudoaneurysm compresses both ventricular cavities. The arrow points to the mitral valve.
Ao = aorta; LA = left atrium; LV = left ventricle; RV = right ventricle

Computed tomogram of the chest (cross-sectional view) shows a large, narrow-necked pseudoaneurysm (arrow) arising from the ascending aorta and lined circumferentially by intramural thrombus.

Contrast-enhanced computed tomograms (3-dimensional reconstruction) show a large pseudoaneurysm of the ascending aorta in A) coronal and B) sagittal views.
AscAo = ascending aorta; PsA = pseudoaneurysm
Contributor Notes
Section Editor: Raymond F. Stainback, MD, Department of Adult Cardiology, Texas Heart Institute, 6624 Fannin St., Suite 2480, Houston, TX 77030
From: Department of Cardiology, University of Illinois College of Medicine at Peoria, Peoria, Illinois 61605