Aortic Valve–Sparing Repair of a Giant Left Ventricular Outflow Tract Pseudoaneurysm With Severe Aortic Regurgitation

BACKGROUND: Left ventricular outflow tract (LVOT) pseudoaneurysms are rare but life-threatening entities arising from various etiologies, including infections, inflammation, and iatrogenic trauma. CASE SUMMARY: A 39-year-old man presented with pleuritic chest pain, fever, and cough. He was initially treated for pneumonia but was later found to have a giant LVOT pseudoaneurysm on multimodality imaging. Infectious and inflammatory causes were ruled out. Surgical repair was successfully performed using a valve-sparing approach with a bovine pericardial patch. Postoperatively, the patient had a favorable outcome with preserved aortic valve function. DISCUSSION: This case highlights the diagnostic challenges and surgical strategy of valve preservation in LVOT pseudoaneurysm management. TAKE-HOME MESSAGES: Rapid multimodal imaging and urgent surgical intervention are imperative to avert potentially fatal rupture of LVOT pseudoaneurysms. Valve-sparing repair techniques, even in anatomically complex pseudoaneurysms, can reliably preserve native valve function when performed at high expertise centers.