Kadner Alexander, Fasnacht Margrit, Kretschmar Oliver, Prêtre René
Division of Congenital Cardiac Surgery, Children's Hospital, University Zurich, Switzerland.
Eur J Cardiothorac Surg. 2007 May;31(5):949-51. doi: 10.1016/j.ejcts.2007.01.068. Epub 2007 Mar 6.
A 8-year-old boy showed a traumatic ventricular septal rupture following a blunt chest trauma, and was scheduled for elective catheter closure. Two weeks later, a follow-up echocardiogram revealed a pseudoaneurysm of the anterior wall of the left ventricle. Because of the apical location of the VSD, it was decided to proceed with transcatheter occlusion. After successful VSD closure, the patient was taken to the operation room for surgical repair of the left ventricular pseudoaneurysm. Symptoms and signs seen in patients with ventricular pseudoaneurysms appear to be discrete and variable, and a high clinical index of suspicion with a very close echocardiographic follow-up is strongly recommended after occurrence of a blunt cardiac trauma. The combined 'hybrid' approach of transcatheter closure of the intraventricular rupture followed by surgical closure of the pseudoaneurysm allows for a less invasive and efficient management of this rare combination of post-traumatic ventricular free wall and septal rupture in a child.
一名8岁男孩在胸部钝性创伤后出现创伤性室间隔破裂，计划择期进行导管封堵术。两周后，随访超声心动图显示左心室前壁假性动脉瘤形成。由于室间隔缺损位于心尖部，决定行经导管封堵术。室间隔缺损成功封堵后，患者被送往手术室进行左心室假性动脉瘤的手术修复。室性假性动脉瘤患者出现的症状和体征似乎各不相同且具有变异性，强烈建议在钝性心脏创伤发生后进行高度临床怀疑并密切超声心动图随访。经导管封堵心室破裂后再行假性动脉瘤手术封堵的联合“杂交”方法，可对儿童创伤后罕见的心室游离壁和室间隔破裂组合进行微创且有效的治疗。
