Left Ventricular Pseudoaneurysm Following Atrioventricular Groove Disruption in a Patient With Native Valve Endocarditis

Left ventricular (LV) pseudoaneurysm is a rare and life-threatening sequela of atrioventricular (AV) groove disruption. A 73-year-old woman with giant cell arteritis on immunosuppressive therapy presented with dyspnea. Blood cultures revealed Enterococcus faecalis native mitral and aortic valve endocarditis with severe mitral and aortic regurgitation. She underwent bioprosthetic aortic and mitral valve replacement. After separation from cardiopulmonary bypass, she developed refractory AV groove bleeding requiring venoarterial extracorporeal membrane oxygenation. After decannulation and recovery, she returned with dysrhythmia and was diagnosed with an LV pseudoaneurysm, necessitating surgical reintervention. It is important to recognize LV pseudoaneurysm as a rare but serious complication of valve surgery, especially after AV groove bleeding. Timely diagnosis and surgical intervention are essential for patient survival. LV pseudoaneurysm is a rare but life-threatening complication after valve surgery, especially in high-risk patients. Prompt diagnosis and surgical repair are critical for survival.