Fistulous Pseudoaneurysm Complicating Surgical Accessory Pathway Interruption for Wolff-Parkinson-White Syndrome THOMAS L. SALAZER, M.D., J. MICHAEL.

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Fistulous Pseudoaneurysm Complicating Surgical Accessory Pathway Interruption for Wolff-Parkinson-White Syndrome THOMAS L. SALAZER, M.D., J. MICHAEL BACHARACH, M.D., JOHN F. BRESNAHAN, M.D., JAMES B. SEWARD, M.D., GORDON K. DANIELSON, M.D. Mayo Clinic Proceedings Volume 67, Issue 7, Pages 663-666 (July 1992) DOI: 10.1016/S0025-6196(12)60722-8 Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 A, Transesophageal echocardiographic four-chamber view, demonstrating an ovoid space adjacent to mitral annulus (arrow). B, Magnification of region shown in A, clearly delineating communication of pseudoaneurysm (large arrow) with left atrium (small arrow). C, Color flow Doppler image, demonstrating systolic flow from pseudoaneurysm to left atrium across orifice of mitral valve (small arrows). Large arrows = mitral valve leaflets. LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle. Mayo Clinic Proceedings 1992 67, 663-666DOI: (10.1016/S0025-6196(12)60722-8) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Lateral view of left ventriculogram, showing opacification of pseudoaneurysm (figure within arrows is retouched). Ao = aorta; LV = left ventricle. Mayo Clinic Proceedings 1992 67, 663-666DOI: (10.1016/S0025-6196(12)60722-8) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Four-chamber ultrafast cine computed tomographic image, accurately demonstrating pseudoaneurysm (arrow). LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle. Mayo Clinic Proceedings 1992 67, 663-666DOI: (10.1016/S0025-6196(12)60722-8) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Operative photograph of opened fistula as exposed through incisions in right atrium and atrial septum. Mayo Clinic Proceedings 1992 67, 663-666DOI: (10.1016/S0025-6196(12)60722-8) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 Diagram of anatomy shown in Figure 4. Fistula is located on left lateral atrioventricular groove; atrial orifice is depicted within square. Inset shows cross-sectional view of same area. (This view corresponds to that in Figure 1 C.) An = pseudoaneurysm; CCA = circumflex coronary artery; CS = coronary sinus; LA = left atrium; LV = left ventricle; MV = mitral valve. Mayo Clinic Proceedings 1992 67, 663-666DOI: (10.1016/S0025-6196(12)60722-8) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions