Pseudoaneurysm of Ascending Aorta with Fistulization to Left Atrium after Coronary Artery Bypass Graft Surgery

A 53-year-old man with a history of coronary artery bypass graft surgery 4 years previously was admitted to our hospital with dyspnea on exertion (New York Heart Association class II) ^1 of three months’ duration, lower extremities edema of two weeks’ duration, and pulmonary edema of two weeks’ duration. Transthoracic and transesophageal echocardiographic examinations revealed pseudoaneurysm of the ascending aorta with fistulization to the left atrium. He was, therefore, scheduled for surgery, during which repair of the ascending aorta with a pericardial patch in conjunction with repair of the aortic valve and removal of the fistulization between the left atrium and ascending aorta was performed. The patient was discharged ten days after admission in very good physical condition. Postoperative echocardiography demonstrated only mild aortic regurgitation and no residual connection between the left atrium and ascending aorta, with the latter having a normal size