Right Coronary Artery Button Pseudoaneurysm After the Modified Bentall Procedure

Figures

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  Figure 1. Preoperative computed tomography angiography of the chest. Large pericardial hematoma in retrosternal space (thin red arrow) with active extravasation (bold yellow arrow) from the right coronary artery re-implantation site: (A) axial view and (B) three-dimensional reconstruction.

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  Figure 2. Intraoperative transesophageal echocardiogram images. Pseudoaneurysm with hematoma indicated by a thin red arrow. (A) Mid-esophageal aortic valve long-axis view: right coronary artery (RCA) button pseudoaneurysm anterior to the ascending aorta (Ao). (B) Upper esophageal ascending aortic short-axis view: pseudoaneurysm with compression of the right atrium (RA). (C) Color flow Doppler: two jets of blood flow (thick yellow arrows) visualized feeding pseudoaneurysm. (D) Color flow Doppler: post-repair of the RCA button and evacuation of the hematoma.

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  Figure 3. Illustration of the right coronary artery button before repair. Polypropylene pseudoknot at the six o’clock position (red arrow), and areas of active extravasation at the two and eight o’clock positions (yellow stars).