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oai:recercat.cat:11351/102982025-10-24T10:29:53Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:29:53Z urn:hdl:11351/10298 Atypical presentation and percutaneous repair of ascending aortic pseudoaneurysm: a case report Tobías-Castillo, Pablo Eduardo Reyes Juarez, Jose L Martí Aguasca, Gerard Oristrell, Gerard Aneurismes aòrtics - Cirurgia Cor - Cirurgia - Complicacions Angiografia ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Cardiac Surgical Procedures Other subheadings::Other subheadings::Other subheadings::/adverse effects DISEASES::Cardiovascular Diseases::Vascular Diseases::Aneurysm::Aneurysm, False Other subheadings::Other subheadings::Other subheadings::/surgery ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, X-Ray Computed::Computed Tomography Angiography TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos cardiovasculares::procedimientos quirúrgicos cardíacos Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::aneurisma::aneurisma falso Otros calificadores::Otros calificadores::Otros calificadores::/cirugía TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada por rayos X::angiografía por tomografía computarizada Pseudoaneurisma aòrtic; Tancament percutani; Síncope Pseudoaneurisma aórtico; Cierre percutáneo; Síncope Aortic pseudoaneurysm; Percutaneous closure; Syncope Background Ascending aortic pseudoaneurysms (AAPs) are an unusual complication of cardiac or aortic surgery and are associated with a high risk of complications and mortality. Guidelines recommend surgical repair. There is few data concerning percutaneous occlusion of AAP. We present a case of syncope due to vascular and heart chamber compression by a large post-surgical AAP that was filled through a focal leak. Ascending aortic pseudoaneurysm was successfully occluded percutaneously. Case summary A 66-year-old man with a mechanical aortic prosthesis and a Dacron tube in the ascending aorta presented with syncope due to compression of the right atrium and superior vena cava by a large peritube collection. A computed tomography angiography (CTA) showed a large AAP that was filled through a small focal dehiscence of the tube proximal suture. Patient was dismissed for surgery due to high surgical risk. Then, AAP was successfully occluded percutaneously via a 6-French radial access and local anaesthesia. Discussion In patients with syncope and previous cardiac surgery, aortic complications should be ruled out. Although transthoracic echocardiography may be useful, CTA is the recommended diagnostic test for ruling out post-surgical AAP and allows the characterization of the number, localization, and size of the leaks. In selected patients with high surgical risk and favourable anatomic characteristics, a percutaneous closure could be indicated. 2025-10-24T10:29:53Z 2025-10-24T10:29:53Z 2023-09-19T09:07:01Z 2023-09-19T09:07:01Z 2023-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/10298 European Heart Journal - Case Reports;7(9) https://doi.org/10.1093/ehjcr/ytad414 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Scientia