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Pseudoaneurysms of the heart.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hulten, Edward A. Blankstein, Ron |
| Copyright Year | 2012 |
| Abstract | Case 1 : An 85-year-old man with a history of ischemic cardiomyopathy and recent reoperation coronary bypass surgery was noted on a routine follow-up echocardiogram to have a 25×25-mm fluid-filled extracardiac mass adjacent to the basal inferolateral wall of the left ventricle (Figure 1). Cardiac computed tomography (CT) identified the structure to be a pseudoaneurysm of a saphenous vein graft to an obtuse marginal branch of the left circumflex coronary artery. How should this patient be managed? Figure 1. Saphenous vein graft (SVG) pseudoaneurysm in an 85-year-old man after recent reoperation coronary artery bypass surgery. The pseudoaneurysm was visible as a mass (arrow) in the left atrioventricular (AV) groove on the chest x-ray ( A ). Transthoracic echocardiography ( B ) demonstrated a vascular mass (arrow) adjacent to the basal lateral wall. Cardiac computed tomographic angiography ( C ) demonstrated the pseudoaneurysm (arrow) connecting to the SVG by a narrow neck with contrast enhancement (light gray) and some thrombus (dark gray). Four-chamber view ( D ) demonstrating the pseudoaneurysm (arrow) in the left AV groove; a magnified view ( D , inset) demonstrates the pseudoaneurysm connected to the SVG via a narrow neck (arrow) with active contrast extravasation (red outline) contained by thrombus (white outline). Invasive angiography showing contrast extravasation ( E ) into the pseudoaneurysm (arrow) and postintervention angiogram demonstrated successful occlusion of the pseudoaneurysm ( F ). LA indicates left atrium; LV, left ventricle. Case 2 : A 27-year old man with prior homograft aortic valve replacement developed recurrent endocarditis (Figure 2). Echocardiography noted a periaortic valvular fluid collection concerning for abscess or valvular dehiscence. However, Doppler signal to and from the fluid collection connecting to the left ventricular outflow tract also raised concern for pseudoaneurysm. Cardiac CT confirmed the structure to be a 37×32-mm pseudoaneurysm involving the left coronary cusp of a trileaflet homograft prosthetic aortic valve just below the takeoff of … |
| Starting Page | 893 |
| Ending Page | 900 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/125/15/1920.full.pdf?download=true |
| PubMed reference number | 22508841v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/CIRCULATIONAHA.111.043984 |
| DOI | 10.1161/circulationaha.111.043984 |
| Journal | Circulation |
| Volume Number | 125 |
| Issue Number | 15 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Allograft surgical material Aortic valve structure Cardiomyopathies Coronary Artery Bypass Surgery Echocardiography Ejection fraction (procedure) Endocarditis False aneurysm of artery Fill Heart Ventricle Heart valve disease Implants Ischemic cardiomyopathy Left Ventricular Outflow Tract Left ventricular structure Magnetic Resonance Imaging Myocardial Infarction Obstruction Outflow tract of left ventricle Patients Premature ventricular contractions Pseudoaneurysm Repeat Surgery Reproductive dehiscence Right coronary artery structure Saphenous vein graft Shock, Cardiogenic Structure of circumflex branch of left coronary artery X-Ray Computed Tomography angiogram |
| Content Type | Text |
| Resource Type | Article |
