Giant aortic root pseudoaneurysm surrounding the left main coronary artery

A 69-year-old patient underwent an urgent aortic valve replacement because of Streptococcus agalactiae endocarditis of his native aortic valve. Since a rapid progression of the former abscess cavity into an aortic root pseudoaneurysm with increasing paravalvular regurgitation during postoperative follow-up, reoperation was performed. In the preoperative transesophageal echocardiography (TEE) images the pseudoaneurysm completely surrounds the left coronary artery (LCA) without any signs of myocardial ischemia