Kumar Swasthi S, Mondal Sudipta, Radhakrishnan Jayakrishnan, Das Ramya
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India.
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India.
Eur Heart J Case Rep. 2025 Jul 15;9(7):ytaf308. doi: 10.1093/ehjcr/ytaf308. eCollection 2025 Jul.
Dissecting aneurysm of the interventricular septum (DAIS) is a rare congenital or acquired anomaly which can have a progressive course. We report a large DAIS incidentally detected by a routine echocardiogram.
An asymptomatic tricenarian was incidentally detected to a DAIS during a routine pre-operative evaluation. Multimodality imaging with cardiac CT, MRI, and aortic root angiograms confirmed the diagnosis. Work-up for infectious causes like syphilis and inflammatory causes like connective tissue disorders were negative. Patient is planned for surgical repair.
Dissecting aneurysm of the interventricular septum is a rare anomaly with a poor prognosis. The rupture of sinus of Valsalva aneurysm is the most common cause. Infections like syphilis and infective endocarditis, connective tissue disorders (Marfan syndrome and Ehler-Danlos syndrome), autoimmune diseases (Behcet's disease, ankylosing spondylitis, systemic lupus erythematosus, Takayasu's arteritis), bicuspid aortic valve with aortopathy, atherosclerosis, surgery, or trauma are the reported causes. Such dissecting aneurysms can have a progressive course, leading to right or left ventricular outflow tract obstructions, severe aortic regurgitation, and rupture into ventricular chambers, portending a grave prognosis. Hence, surgical correction is the norm.
室间隔夹层动脉瘤（DAIS）是一种罕见的先天性或后天性异常，其病情可能呈进行性发展。我们报告一例通过常规超声心动图偶然发现的大型DAIS。
一名无症状的30岁患者在术前常规评估中偶然发现患有DAIS。心脏CT、MRI和主动脉根部血管造影等多模态成像确诊了该疾病。梅毒等感染性病因及结缔组织病等炎性病因的相关检查均为阴性。患者计划接受手术修复。
室间隔夹层动脉瘤是一种罕见的异常疾病，预后较差。主动脉窦瘤破裂是最常见的病因。梅毒、感染性心内膜炎等感染，结缔组织病（马凡综合征和埃勒斯-丹洛斯综合征），自身免疫性疾病（白塞病、强直性脊柱炎、系统性红斑狼疮、高安动脉炎），合并主动脉病变的二叶式主动脉瓣，动脉粥样硬化，手术或创伤等均为已报道的病因。此类夹层动脉瘤病情可能呈进行性发展，导致右或左心室流出道梗阻、严重主动脉瓣反流，并破裂入心室腔，预后严重。因此，手术矫正为常规治疗方法。
