Sternal erosion detected by computed tomographic angiography before repeat sternotomy in an adolescent with congenital heart disease

Received 29 August 2009; accepted 11 November 2009. published online 30 November 2009.

Abstract

The case of a 17-year-old male with congenital heart disease who was found to have erosion of a pseudoaneurysm into his posterior sternum is presented. The pseudoaneurysm originated from a right ventricle–to–pulmonary artery homograft, which had been placed 11 years before. It had not been appreciated by echocardiography. The pseudoaneurysm and erosion were visualized with computed tomographic angiography before scheduled surgical replacement of the homograft. This unexpected finding was critical for operative planning and was confirmed on direct visualization in the operating room.

Keywords: Computed tomographic angiography, Congenital heart disease, Pseudoaneurysm, Pulmonary homograft, Repeat sternotomy

a College of Medicine, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150, USA

b Departments of Radiology and Radiological Science and Medicine, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150, USA

c Departments of Surgery and Pediatric Cardiothoracic Surgery, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150, USA

d Department of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150, USA

Corresponding author.

Conflict of interest: The authors report no conflicts of interest.

PII: S1934-5925(09)00527-9

doi:10.1016/j.jcct.2009.11.005

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