What does this research mean for the field?

Ascending aortic pseudoaneurysm can develop as a rare, multifactorial complication after transcatheter aortic valve replacement combined with cardiothoracic surgery and sternal wire friction, warranting urgent surgical intervention. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Detail the presentation, multifactorial etiology, and surgical management of a rare ascending aortic pseudoaneurysm following transcatheter aortic valve replacement and bilateral lung transplantation.

August 4, 2026Circulation Cardiovascular ImagingOpen Access

Ascending Aortic Pseudoaneurysm: A Rare Complication of Transcatheter Aortic Valve Replacement and Thoracic Surgery

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Detail the presentation, multifactorial etiology, and surgical management of a rare ascending aortic pseudoaneurysm following transcatheter aortic valve replacement and bilateral lung transplantation.
Evaluated a 64-year-old male with previous transcatheter aortic valve replacement (TAVR) and bilateral orthotopic lung transplant who presented with an incidental retrosternal mass on surveillance chest CT.
Conducted chest CT angiography with three-dimensional volume rendering to delineate the spatial relationship between the pseudoaneurysm, TAVR frame, and sternal wires.
Performed emergent pseudoaneurysm repair, surgical aortic valve replacement with a bioprosthetic valve, chest wall debridement, and culture-directed antibiotic therapy.
Identified a 4.9 cm ascending aortic pseudoaneurysm with a 1.8 cm × 2.6 cm neck adhering to sternal wires, through which TAVR struts protruded outside the aorta.
Cultured Staphylococcus epidermidis from the pseudoaneurysm and chest wound, whereas blood cultures and explanted valve components showed no bacterial growth.
Documented stable postsurgical changes on repeat CT at two months and preserved lung allograft function without cardiovascular symptoms at five months.

Structured PICO

Population

64-year-old male with a history of transcatheter aortic valve replacement (TAVR) and bilateral orthotopic lung transplant (BOLT) for chronic obstructive pulmonary disease secondary to alpha-1 antitrypsin deficiency.

Intervention

Concomitant emergent pseudoaneurysm repair and surgical aortic valve replacement (SAVR) with a 25 mm Edwards Inspiris Resilia bioprosthetic valve, wound debridement, and 6-week daptomycin followed by lifelong doxycycline.

Outcome

Survival and stable postsurgical changes at 5 months follow-up.

Implication

Ascending aortic pseudoaneurysm is a rare but life-threatening complication after TAVR and thoracic surgery that can be successfully managed with emergent surgical repair.

Discussion

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Cite This Study

Cai et al. (2022) studied this question.

synapsesocial.com/papers/6a7164e9fe4101aa97e08e6f https://doi.org/10.1161/circimaging.122.014076

Topics

Transcatheter aortic valve replacement

TAVR in low-risk patients

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Implication

Ascending aortic pseudoaneurysm is a rare but life-threatening complication after TAVR and thoracic surgery that can be successfully managed with emergent surgical repair.

Ascending Aortic Pseudoaneurysm: A Rare Complication of Transcatheter Aortic Valve Replacement and Thoracic Surgery

Key Points

Structured PICO

Implication

Discussion

Cite This Study

Topics

Ascending Aortic Pseudoaneurysm: A Rare Complication of Transcatheter Aortic Valve Replacement and Thoracic Surgery

Key Points

Structured PICO

Implication

Discussion

Cite This Study

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