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J Thorac Cardiovasc Surg 2009;138:236-237
© 2009 The American Association for Thoracic Surgery

Brief Clinical Report

Aortic pseudoaneurysm compressing the left coronary artery

George V. Moukarbel, MDa,*, Hani Jneid, MDa, Jennifer D. Walker, MDb, Joseph M. Garasic, MDa, Thomas J. Wang, MDa

a Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
b Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Received for publication February 5, 2008; accepted for publication February 14, 2008.

* Address for reprints: George V. Moukarbel, MD, Cardiology Division, GRB-800, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114. (Email: moukarbel.george@mgh.harvard.edu).

The first 20% of the full text of this article appears below.


   Introduction
 
We report a patient with an aortic pseudoaneurysm compressing the left coronary artery, causing acute ischemic left ventricular dysfunction.


   Clinical Summary
 
A 52-year-old man presented with acute myocardial infarction and cardiogenic shock 18 months after undergoing bioprosthetic mitral valve and homograft aortic root replacement for a dilated aortic root and severe aortic and mitral insufficiency. His cardiac catheterization at the time of surgery showed normal coronary arteries (Figure 1, A ). On presentation to the Massachusetts General Hospital, he was noted to have severe left ventricular dysfunction, elevated cardiac enzymes (CK-MB 50.4 ng/mL; troponin T 5.03 ng/mL), and cardiogenic shock. The patient underwent emergency placement of an intra-aortic balloon pump . . . [Full Text of this Article]






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