An exceptional case of a huge pseudoaneurysm caused by an epicardial electrode

Our patient have a history of aortic valve replacemet since 18 years ago with mecanical valve. After sternotomy there is a huge pseudoaneurysm measuring 70 mm of the aortic root (A, B), totally adhering to the right atrium, which is pushed back and compressed. The aorta will be opened vertically downwards, allowing to see this enormous pseudoaneurysm encompassing the right coronary sinus (C). At this level it exists a perforation of the aorta by an epicardial electrode and caused this pseudoaneurysm (D), which we had left in place 18 years ago to stimulate the right atrium. We finished the operation with a segment I replacement by a Dacron tube.