Complementary role of cardiac computed tomography and Doppler-echocardiography in the evaluation of an uncommon case of giant pseudoaneurysm of ascending aorta complicated by fistula to the pulmonary artery

This report describes the case of previous type-A aortic dissection treated with the placement of a termino-terminal prosthesis, which developed a large peri-prosthetic pseudoaneurysmatic sac, detected by CT, performed 2 years after the surgery. This raised the suspicion of a communication between the pseudoaneurysmatic sac and the aortic lumen, but was not able to show it directly. Transthoracic echocardiography confirmed the presence of the fistula, showing a systo-diastolic color Doppler jet signal connecting these two structures.The complementary role of these two diagnostic techniques allowed a complete evaluation of this complex pathology.