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Asymptomatic pseudoaneurysm of the ascending aorta diagnosed due to accompanying infection of a right atrial embolus

Division of Cardiothoracic Surgery, University of Alberta, Edmonton, Alta, Canada

^* Corresponding author. Department of Cardiac Surgery, University of Munich, Klinikum Augustinum, Wolkerweg 16, 81375 Munich, Germany. Tel.: +49-89-7097-1817; fax: +49-89-7097-1848
wildhirt{at}gmx.net

We present a case of a large pseudoaneurysm of the ascending aorta, originating from the purse-string suture of the cardioplegia line which was essentially asymtomatic but was diagnosed during patient follow up for fever and elevated white blood count of unknown origin. During intraoperative transesophageal echocardiography, a free floating tumor was localized in his right atrium which after removal appeared to be an infected embolus with excessive neutrophils and monocytoid cells interspersed with cell debris and fibrin. Material send for culture was positive for streptococci, whereas tissues cultures from the pseudoaneurysm were essentially negative. To our knowledge, this is the first report of an asymtomatic, non-infected aortic pseudoaneurysm which was accidentally diagnosed due to concomitant infection of an deep venous thrombus which had embolized into the right atrium.

Key Words: Aortic pseudoaneyrysm; Deep venous thrombosis; Infection