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Huge pseudo-aneurysm of right ventricular outflow tract after patch reconstruction in tetralogy of Fallot

Published online by Cambridge University Press:  28 January 2011

HY Chen ,
CI Chang  and
Shyh-Jye Chen
HY Chen
Affiliation:
Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Fu Jen Catholic University School of Medicine
CI Chang
Affiliation:
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Shyh-Jye Chen*
Affiliation:
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
*
Correspondence to: S-J Chen, MD, PhD, Department of Medical Imaging, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Tel: +886 2 2312 3456, Ext. 70330; Fax: +886-2-2322-4552; E-mail: james_5586@hotmail.com
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Abstract

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Information

Type
Images in Congenital Cardiac Disease
Information
Cardiology in the Young , Volume 21 , Issue 3 , June 2011 , pp. 340
Copyright
Copyright © Cambridge University Press 2011

A 3-year-old girl presented with progressive chest tightness and decreased appetite for 5 days preceding her admission. She was diagnosed with extreme tetralogy of Fallot with pulmonary atresia. She underwent right ventricular outflow tract patch correction and neo-pulmonary trunk reconstruction 40 days previously and was discharged after 20 days. Plain chest radiography showed an abnormal bulging mass-like shadow at the upper left cardiac border (@ in Fig a). Emergent computed tomography (Light-Speed 16-slice; GE Healthcare) scan disclosed a 4 × 5 centimetre lobulated pseudo-aneurysm from the trans-annular right ventricular outflow tract patch (@ in Fig b). Under the impression of leaked right ventricular outflow tract patch with pseudo-aneurysm formation, she underwent emergent aneurysmectomy. The surgical finding confirmed this huge pseudo-aneurysm (@ in Fig c) and the resected specimen by Masson's Trichrome stain (Fig d) revealed no myocardial or vascular wall pathologically with full thickness of collagenous component of the fibrotic tissue (light grey) mixed with petechial haemorrhage (dark grey).

Figure 1

Figure 0

Figure 1