Case of the Month, June 2017, Page 3

The patient presented for a routine postoperative follow-up visit 1 month later complaining of severe chest pressure-like pain radiating to the arms following meals, not relieved with Tums. He denied shortness of breath with exertion. Extensive GI work up including endoscopy and CT abdomen were negative. Echocardiogram was performed and revealed 71% EF with no regional wall motion abnormalities. The aortic valve was noted to be in appropriate position with aortic valve area by the continuity equation (using VTI) is 1.5 cm2, which is within normal limits.

The following day, the patient had a routine follow-up cardiac CT:

 

 

3D reconstruction of cardiac CT demonstrating appropriate placement of aortic valve prosthesis with patent aortic valve.

 However, review of the CT images demonstrated a critical finding...

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