Department of Cardiac Surgery, Tianjin Chest Hospital, Tianjin, China.
Heart Surg Forum. 2020 Aug 25;23(5):E595-E598. doi: 10.1532/hsf.3137.
Pseudoaneurysm (PSA) of the right ventricular outflow tract (RVOT) is an exceedingly rare adverse event after the surgical reconstruction of the RVOT for the treatment of congenital heart disease. We report an unusual giant PSA of RVOT in a 20-month-old child, who underwent correction of the tetralogy of Fallot. Her main symptoms were in the respiratory system, and chest X-ray also revealed the giant space-occupying lesion in the chest, which could've been misdiagnosed as a respiratory disease. After evaluation by the combination of echocardiography and cardiac computer tomography angiogram, the details of PSA were diagnosed, and surgical but not percutaneous intervention was selected. The exclusion of PSA successfully was performed by the femoral cannulation, exploratory through right ventriculotomy, closure of the defect using the Gore-Tex patch, and application of a retained drainage-tube inside the PSA.
右心室流出道（RVOT）假性动脉瘤（PSA）是先天性心脏病 RVOT 手术后重建极为罕见的不良事件。我们报告了一例 20 个月大的儿童 RVOT 巨大 PSA 的不寻常病例，该患儿曾接受法洛四联症的矫正术。她的主要症状是呼吸系统，胸部 X 线片也显示胸部有巨大占位性病变，可能被误诊为呼吸系统疾病。经超声心动图和心脏计算机断层血管造影相结合的评估，明确了 PSA 的详细情况，并选择了手术而非经皮介入治疗。通过股动脉插管、右心室切开探查、戈尔补片封闭缺损、PSA 内留置引流管等方法成功排除 PSA。
