Delayed manifestation of ascending aortic pseudoaneurysm caused by purulent pericarditis 19 years previously: A case report

Abstract

Ascending aortic pseudoaneurysms are a rare, but life-threatening, vascular entity. Infections are the major pathogenesis of aortic pseudoaneurysms, and the majority of them that are caused by infections commonly develop at the acute or subacute infectious phase. We report a 60-year-old man, with no conceivable causes of aortic pseudoaneurysm formation, except for purulent pericarditis 19 years previously, who presented with palpitation and dyspnea due to a pseudoaneurysm. Computed tomography showed that an ascending aortic pseudoaneurysm measuring 70 mm, which was not present in follow-up computed tomography scans at 1 and 2 years after purulent pericarditis, had compressed adjacent structures. We performed an open surgical repair with a Dacron prosthetic graft for the pseudoaneurysm. Delayed manifestation of aortic pseudoaneurysm rarely occurs in patients with infections, such as purulent pericarditis, which can invade the aortic wall. Therefore, careful follow-up and serial systemic imaging screening are recommended in these patients, even if infections are completely cured.