Sixty-four–slice computed tomographic coronary angiography in pseudoaneurysm of the ascending aorta: A useful modality to supplement the diagnosis Lars.

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Sixty-four–slice computed tomographic coronary angiography in pseudoaneurysm of the ascending aorta: A useful modality to supplement the diagnosis Lars Husmann, MD, Sebastian Leschka, MD, Sacha P. Salzberg, MD, Mario Lachat, MD, Michele Genoni, MD, Borut Marincek, MD, Hatem Alkadhi, MD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 2, Pages e17-e19 (August 2006) DOI: 10.1016/j.jtcvs.2006.05.002 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Invasive coronary angiography demonstrates the injection of contrast material into the pseudoaneurysm (asterisk) on the right side (A), into the composite graft (B), and into the pseudoaneurysm on the left side (C). Because of the exceptional anatomy of the aortic root, selective catheterization of both coronary ostia failed, and nonselective injection of contrast material yielded only insufficient opacification of the coronary arteries (black arrowhead: left main artery). The Journal of Thoracic and Cardiovascular Surgery 2006 132, e17-e19DOI: (10.1016/j.jtcvs.2006.05.002) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Sixty-four–slice CT after intravenous injection of contrast material with oblique coronal reconstruction (A), transverse reconstruction at the level of the coronary ostia (B), and volume rendered 3-dimensional image of the coronary artery tree (C). CT accurately depicts the covered rupture of the composite graft at the distal anastomosis creating a pseudoaneurysm (asterisk) that surrounded the graft and reached the level of the mechanical aortic valve prosthesis. Irregular thickening (white arrow) of the composite graft membrane adjacent to the rupture site (white arrowhead) indicated thrombotic material. The relationship of the origin of the left (black arrowhead) and right (black arrow) coronary arteries to the graft and pseudoaneurysm can be readily appreciated on the transverse image. The volume rendered 3-dimensional image demonstrates normal opacification of the coronary artery tree with no evidence of coronary stenoses. The Journal of Thoracic and Cardiovascular Surgery 2006 132, e17-e19DOI: (10.1016/j.jtcvs.2006.05.002) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions