Hemoptysis following left ventricular aneurysm repair - A misleading clinical sign

We report on a 66-year-old man with severe hemoptysis following coronary ar tery bypass grafting and repair of a left ventricular septal defect after a cute myocardial infarction. Initial diagnosis was delayed by misleading cli nical symptoms and radiologic studies. Due to subfebrile temperature and sp utum culture positive for Pseudomonas aeruginosa, he had been treated with antibiotics before reoperation. At reoperation, replacement of all foreign material and reconstruction of the ventricular repair with bovine pericardi um resulted in reinfection with the same organism despite prolonged antibio tic therapy after 6 months. Removal of the pericardial tissue with direct s uture closure of the ventricles and interposition of omentum led to complet e healing of the infection without reoccurrence after 2 years.