Demirtürk Orhan Saim, Karadeli Elif, Alemdaroglu Utku, Yilmaz Mustafa
Department of Cardiovascular Surgery, Baskent University Adana Medical Center, Adana, Turkey.
Departrment of Radiology, Baskent University Adana Medical Center, Adana, Turkey.
Interact Cardiovasc Thorac Surg. 2017 Jun 1;24(6):962-963. doi: 10.1093/icvts/ivx037.
Cardiac pseudoaneurysm is a contained rupture of the myocardium limited by pericardial adhesions or the epicardial wall. Cardiac pseudoaneurysm may cause sudden death with a mortality of 30-45% in the first year, mostly resulting from rupture. Coronal and axial T2-weighted magnetic resonance images of a 65-year-old male patient admitted with dyspnoea, coughing and chest pain, present for the last 10 days, revealed a large pseudoaneursym of the left ventricle. Coronary bypass and left ventricular restoration operation was performed. The patient was eventlessly discharged 8 days after operation. He is in NYHA Class I 21 months postoperatively. The interval between myocardial insult and establishment of diagnosis is unknown in our patient. This is a patient whose left ventricular rupture had been contained for a very long time, possibly years, because a heavily calcified thick pseudoaneurysm wall was encountered during operation, making this case rare in the literature.
心脏假性动脉瘤是心肌的局限性破裂,由心包粘连或心外膜壁限制。心脏假性动脉瘤可导致猝死,第一年死亡率为30% - 45%,主要原因是破裂。一名65岁男性患者因呼吸困难、咳嗽和胸痛入院,症状持续了10天,其冠状位和轴位T2加权磁共振图像显示左心室有一个大的假性动脉瘤。患者接受了冠状动脉搭桥和左心室修复手术。术后8天患者顺利出院。术后21个月,患者纽约心脏协会(NYHA)心功能分级为I级。在我们的患者中,心肌损伤与确诊之间的时间间隔未知。这是一名左心室破裂被包裹很长时间的患者,可能长达数年,因为手术中遇到了严重钙化的增厚假性动脉瘤壁,这使得该病例在文献中较为罕见。