PMC10010877_01
Pseudoaneurysm arising from a CABG graft. (a) and (b) A blush of contrast consistent with a potential pseudoaneurysm could be seen arising from the SV aorta-rPDA graft. It was embedded in a mediastinal hematoma. (c) Left heart catheterization confirmed the presence of a pseudoaneurysm arising from the SV aorta-rPDA graft.
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CT chest with contrast was then obtained, which showed a 1.5 cm blush of contrast at the level of the SV aorta-rPDA graft that was embedded in the same mediastinal mass seen on prior CT (Figures 1(a) and 1(b)). Subsequent left heart catheterization confirmed a pseudoaneurysm arising from the SV aorta-rPDA graft measuring approximately 1.5 cm in diameter (Figure 1(c); Video 1).
Spontaneous closure of pseudoaneurysm. (a) During left heart catheterization approximately four weeks after initial presentation, there was no detectable pseudoaneurysm, consistent with spontaneous closure. (b) On follow-up CT imaging approximately three and a half months after initial presentation, there was again no detectable pseudoaneurysm and the mediastinal hematoma had decreased in size.
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Repeat left heart catheterization three weeks after discharge showed a patent SV aorta-rPDA with spontaneous resolution of the pseudoaneurysm (Figure 2(a); Video 2), thus precluding use of the stent. Cardiac CT with three-dimensional angiography approximately three and a half months after initial presentation showed persistent resolution of the pseudoaneurysm, with a hematoma that had decreased in both size and density (Figure 2(b)).