Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
J Card Surg. 2021 Dec;36(12):4751-4753. doi: 10.1111/jocs.16064. Epub 2021 Oct 13.
Ruptured interventricular septal aneurysms are rare. We present a case of an interventricular membranous septal aneurysm in a 7-year-old boy who presented with features of congestive heart failure, 2 years after undergoing a patch closure of perimembranous ventricular septal defect and tricuspid valve repair. Material and methods and results: Transthoracic echocardiography suggested the presence of an aneurysm that has ruptured into the right ventricle (RV), however, the precise origin of the aneurysm could not be identified on echocardiography. Subsequently, a computed tomography (CT) angiography was done which revealed that the aneurysm was originating from the membranous interventricular septum with evidence of rupture into the RV inflow.
Due to its close proximity to the aortic annulus, an aneurysm of the membranous interventricular septum may be confused with a sinus of Valsalva aneurysm, especially if the former is associated with aortic regurgitation.
This case highlights the importance of CT in the precise differentiation of these two abnormalities.
室间隔破裂性动脉瘤罕见。我们报告了一例 7 岁男孩的室间隔膜部瘤病例，该男孩在接受室间隔膜部缺损修补和三尖瓣修复术后 2 年，出现充血性心力衰竭的特征。
经胸超声心动图提示存在一个已破裂至右心室（RV）的动脉瘤，但超声心动图无法确定动脉瘤的确切起源。随后进行了计算机断层扫描（CT）血管造影，结果显示该动脉瘤起源于室间隔膜部，有证据表明其已破裂进入 RV 流入道。
由于其靠近主动脉瓣环，膜部室间隔动脉瘤可能与主动脉窦瘤混淆，尤其是当前者伴有主动脉瓣反流时。
本病例强调了 CT 在这两种异常的精确鉴别中的重要性。
