Kupari M, Verkkala K, Maamies T, Härtel G
Br Heart J. 1987 Jul;58(1):52-6. doi: 10.1136/hrt.58.1.52.
The development of a left ventricular pseudoaneurysm is a rare complication of heart surgery. Until recently it has been impossible to detect without an angiographic study of the left ventricle. A combination of cross sectional and Doppler ultrasound studies led to the correct diagnosis in two patients with left ventricular pseudoaneurysms after mitral valve replacement. Cross sectional echocardiography showed a posterolateral echo-free space confined only by the pericardium and communicating with the left ventricle through a defect in the ventricular wall, and Doppler echocardiography confirmed the presence of blood flow in this cavity. This Doppler finding is critical if the perforation is too small to be identified reliably by cross sectional imaging. Surgical repair of the pseudoaneurysm can be undertaken without invasive studies if the echocardiographic findings are unequivocal and there is no reason to suspect the integrity of the circumflex coronary artery.
左心室假性动脉瘤的形成是心脏手术中一种罕见的并发症。直到最近，若不进行左心室血管造影研究，就不可能检测到它。在二尖瓣置换术后的两名左心室假性动脉瘤患者中，经胸超声心动图和多普勒超声检查相结合得出了正确诊断。经胸超声心动图显示，仅由心包限制的后外侧无回声区，通过心室壁上的缺损与左心室相通，多普勒超声心动图证实该腔隙内存在血流。如果穿孔过小，经胸成像无法可靠识别，这一多普勒检查结果至关重要。如果超声心动图检查结果明确，且没有理由怀疑回旋支冠状动脉的完整性，则无需进行侵入性检查即可对假性动脉瘤进行手术修复。
