Sawka Danielle, Arthur Amy, Maslow Andrew, Asher Shyamal R
Anesthesiology, The Warren Alpert Medical School of Brown University, Providence, USA.
Anesthesiology, Rhode Island Hospital, Brown University, Providence, USA.
Cureus. 2025 Mar 13;17(3):e80519. doi: 10.7759/cureus.80519. eCollection 2025 Mar.
Interventricular membranous septal aneurysm (IVMSA) is a rare cardiac anomaly that typically coexists with other cardiac malformations. Recognition of IVMSAs is important for risk mitigation of potentially serious complications such as right ventricular outflow obstruction and proper characterization of the lesion is critical for planning of surgical repair. Literature reports of this condition are sparse and appear limited to case reports. Bicuspid aortic valve (BAV) is a common congenital cardiac malformation tending to present later in life with symptomatic stenosis and is frequently associated with other defects. We report an unusual case of an elderly woman with a BAV undergoing aortic valve replacement who was incidentally diagnosed with an IVMSA. This case report describes intraoperative transesophageal echocardiogram (TEE) characterization of the IVMSA used to help plan the surgical procedure. TEE accurately visualized the IVMSA's exact anatomic location and impact on cardiac function which led to the decision to surgically repair the IVMSA with an autologous patch. This report also includes a comparative discussion of clinical presentations, diagnostic approaches, and management strategies in previously published IVMSA case reports and considerations for operative management.
室间隔膜部瘤（IVMSA）是一种罕见的心脏异常，通常与其他心脏畸形并存。认识IVMSA对于降低潜在严重并发症（如右心室流出道梗阻）的风险很重要，而对病变进行准确的特征描述对于手术修复的规划至关重要。关于这种情况的文献报道很少，似乎仅限于病例报告。二叶式主动脉瓣（BAV）是一种常见的先天性心脏畸形，往往在生命后期出现有症状的狭窄，并且经常与其他缺陷相关。我们报告了一例不寻常的病例，一名患有BAV的老年女性在接受主动脉瓣置换时偶然被诊断出患有IVMSA。本病例报告描述了用于帮助规划手术过程的IVMSA的术中经食管超声心动图（TEE）特征。TEE准确地显示了IVMSA的确切解剖位置及其对心脏功能的影响，这导致决定用自体补片对IVMSA进行手术修复。本报告还包括对先前发表的IVMSA病例报告中的临床表现、诊断方法和管理策略的比较讨论以及手术管理的考虑因素。
