Abstract
We report a case of a 72-year-old woman who presented with a symptomatic pseudoaneurysm of the ascending aorta. Under a diagnosis of ruptured thoracic aortic aneurysm and cardiac tamponade, an emergency operation was performed. A ruptured saccular pseudoaneurysm, 3 cm in maximum dimension which was located 3 cm distal to the sino-tubular junction, resulted in hematoma formation in the anterior space of the right atrium. An abscess was found on the right side of the ascending aneurysm. After clamping the ascending aorta, a localized saccular pseudoaneurysm was treated by careful debridement of the infected tissue. The ascending aorta was reconstructed using direct suturing of the divided aortic wall. Streptococcus pneumoniae was isolated from cultures of the abscess, aneurysm sac and hematoma. The postoperative course was uneventful with no infectious complication. Antibiotic agents were administered for 12 weeks.
