Antonic Miha, Djordjevic Anze, Mohorko Tamara, Petrovic Rene, Lipovec Robert, Juric Peter
Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia.
SAGE Open Med Case Rep. 2019 Jan 12;7:2050313X18823456. doi: 10.1177/2050313X18823456. eCollection 2019.
Left ventricular pseudoaneurysm is a partial cardiac rupture, contained by the surrounding pericardium that maintains communication with the left ventricular lumen. Whereas most cases of left ventricular pseudoaneurysms are related to myocardial infarction (loss of myocardial integrity), only a handful are associated with valve surgery. We present a female patient, who was admitted for elective mitral valve replacement. After the implantation of the mechanical valve, we encountered a rupture of the atrioventricular groove. After 3 months, a left ventricular pseudoaneurysm was found and the patient was reoperated. The valve was explanted and the inspection of the annulus and previously implanted pericardial patch revealed a loosened stitch on the inferior (ventricular) side. The defect was reinforced with additional stitches and the valve was reimplanted. In conclusion, we report an unusual case with two serious complications after mitral valve replacement - atrioventricular groove rupture and left ventricular pseudoaneurysm.
左心室假性动脉瘤是一种部分性心脏破裂，由周围心包包裹，与左心室腔保持连通。虽然大多数左心室假性动脉瘤病例与心肌梗死（心肌完整性丧失）有关，但只有少数与瓣膜手术相关。我们报告一例女性患者，因择期二尖瓣置换入院。植入机械瓣膜后，我们遇到了房室沟破裂。3个月后，发现左心室假性动脉瘤，患者接受再次手术。取出瓣膜，检查瓣环和先前植入的心包补片时，发现下（心室）侧一针缝线松动。用额外的缝线加强缺损处，重新植入瓣膜。总之，我们报告了一例二尖瓣置换术后出现两种严重并发症——房室沟破裂和左心室假性动脉瘤的罕见病例。
