一名成年患者中导致右心室流出道梗阻的膜性间隔动脉瘤
A Membranous Septal Aneurysm Causing Right Ventricular Outflow Tract Obstruction in an Adult.
作者信息
Privitera Fiorella, Monte Ines Paola, Indelicato Antonino, Tamburino Corrado
机构信息
Department of General Surgery and Medical-Surgery Specialities, University of Catania, Catania CT, Italy.
Department of Cardio-Thorax-Vascular and Transplant, A.O.U. Policlinico Catania, Catania CT, Italy.
出版信息
J Cardiovasc Echogr. 2017 Oct-Dec;27(4):145-148. doi: 10.4103/jcecho.jcecho_21_17.
We describe a case of a 69-year-old female referred for the evaluation of exertional dyspnea, with a small membranous ventricular septal defect (VSD) and right ventricle (RV) outflow tract obstruction. Using transthoracic echo was diagnosed VSD with left to right shunting and transesophageal echo (TEE) was used to a better anatomical characterization. TEE showed a perimembranous subaortic VSD that developed a high-velocity flow in RV. Pulmonary valve appears normal and right ventricular infundibular hypertrophy or double-chambered RV was excluded from the study. Furthermore, TEE showed a malaligned VSD and the presence of perimembranous mobile tissue protruding in RV. We hypothesized that this tissue can be attributed to broken septum aneurysm and protruding during systole, it causes a dynamic RV output tract obstruction.
我们描述了一例69岁女性，因劳力性呼吸困难前来评估，患有小型膜周部室间隔缺损（VSD）和右心室（RV）流出道梗阻。经胸超声心动图诊断为VSD伴有左向右分流，并使用经食管超声心动图（TEE）进行更好的解剖学特征描述。TEE显示膜周部主动脉下VSD在RV中形成高速血流。肺动脉瓣外观正常，研究排除了右心室漏斗部肥厚或双腔RV。此外，TEE显示VSD对位不良以及膜周部有可移动组织突入RV。我们推测该组织可归因于破裂的间隔动脉瘤并在收缩期突出，它导致动态RV输出道梗阻。
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