Pulmonary mycotic pseudo-aneurysm with a prior history of ventricular septal defect. Case report with review of literature.

In general aneurysms of the pulmonary arteries are less frequent than intracranial, aortic or other vascular locations. Infectious causes include bacteria such as Staphylococcus sp and Streptococcus sp, mycobacteria, Treponema pallidium (syphilis) and rarely fungi. We report a 7 year old female with two right-sided parahilar pseudo-aneurysm of fungal origin with a prior history of ventricular septal defect. Pulmonary mycotic pseudo-aneurysms are very rare and require a high suspicion to diagnose. If a patient is still symptomatic for fever and cough for a long time, and consolidation on x-ray is not improving on antibiotics, contrast-enhanced computed tomography is indicated. It can be suspected that the "friable mass attached to ventricular septal defect patch" was a source of fungeal emboli to pulmonary arteries thus giving weight to the infective endocarditis etiology. A prior history of ventricular septal defect repair could favour fungal endocarditis.

Unruptured Noncoronary Sinus of Valsalva Aneurysm Associated with Atrial Septal Defect (ASD).

Sinus of Valsalva aneurysms are rare cardiac anomalies. Incidence of this anomaly is higher in Asian population with male preponderance. Our case highlights a rare association between unruptured sinus of Valsalva aneurysm and atrial septal defect (ASD). Rarely diagnosis of sinus of Valsalva aneurysm is missed on two dimensional echocardiography. Multi slice CT scan is done to confirm echocardiographic findings and to detect any missed complications, other cardiac abnormalities and anatomy for a precise surgical approach.

Rare case of truncus arteriosus with anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) and unilateral left pulmonary artery agenesis.

The incidence of congenital heart disease (CHD) is 2.4-3.8/1000 live births. Up to 70.7 % of all cases of CHD are reported to be benign; complex heart anomalies are extremely rare. Our case is extremely rare, as we report three very rare findings-truncus arteriosus, anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA), and unilateral left pulmonary artery agenesis-in a single patient. Congenital complex cardiac abnormalities are very rare, and two-dimensional echocardiography screening should be supported by cardiac computed tomography (CT). We report a case of truncus arteriosus associated with ARCAPA and left pulmonary artery agenesis diagnosed by cardiac computed tomography; we believe that such an unusual case with all three of these entities has never been reported before.

Pseudoaneurysm Arising from Mitral Aortic Intervalvular Fibrosa (P-MAIVF) Communicating with Left Atrium (LA): Multiple Detector Computed Tomography (MDCT) Evaluation.

BACKGROUND: The entity pseudoaneurysm arising from the mitral aortic intervalvular fibrosa (P-MAIVF) is a rare cardiac finding caused by multiple factors. This entity is usually diagnosed with echocardiography and confirmed with cardiac computed tomography (CT). CASE REPORT: We presented a case of congenital P-MAIVF communicating with the left atrium (LA) and an aberrant right subclavian artery, misdiagnosed as primary mitral regurgitation (MR) in transthoracic echocardiogram (TTE) due to relative contraindications to transesophageal echocardiogram (TEE), revealed in a hemophilic patient, and diagnosed with cardiac CT. CONCLUSIONS: In conclusion, cardiac CT plays a definitive role not only in anatomical assessment and confirmation of the lesion but also in primary diagnostics in patients suspected of MAIVF - especially those with relative and absolute contraindications to TEE.