Honda K, Sekiguchi A, Chikada M, Noma M, Miyamoto T
Division of Cardiovascular Surgery, National Children's Hospital, Tokyo, Japan.
Kyobu Geka. 1999 Sep;52(10):846-9.
A rare case of large congenital right ventricular outflow aneurysm is reported. A 5-year-old girl had been diagnosed as having atrial septal defect and pulmonary valvular stenosis. A large cavity in front of right ventricular outflow was noticed by her follow-up echocardiography. The non-contracting cavity was confirmed as an aneurysm originating from right ventricular outflow tract by angiocardiogram. Surgical resection was performed successfully with concomitant atrial septal defect closure and pulmonary valvular commissurotomy. Histological examination revealed that the wall of the ventricular outflow aneurysm consisted of dense fibrous tissue, contained no myocardium, and the cavity was lined with endocardium. It is reported that rupture of congenital ventricular aneurysm may occur even if there is no symptom. Surgical resection will be recommended especially when increasing in size is diagnosed.
报道了一例罕见的先天性右心室流出道动脉瘤病例。一名5岁女孩被诊断患有房间隔缺损和肺动脉瓣狭窄。随访超声心动图发现右心室流出道前方有一个大腔。心血管造影证实这个无收缩功能的腔是一个起源于右心室流出道的动脉瘤。手术成功切除了动脉瘤,同时闭合了房间隔缺损并进行了肺动脉瓣交界切开术。组织学检查显示,心室流出道动脉瘤壁由致密纤维组织构成,不含心肌,腔内衬有内膜。据报道,即使没有症状,先天性心室动脉瘤也可能发生破裂。尤其是当诊断出动脉瘤尺寸增大时,建议进行手术切除。