1/788. Cardiocutaneous fistula.infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic evaluation, which established the diagnosis, the Teflon pledgets and fistulous tract were successfully surgically removed. Prompt diagnosis depends on a high index of suspicion. Eradication of infection requires excision of infected material, which must be planned on an individual basis.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/788. Pseudoaneurysm of the left ventricle after isolated pericarditis and staphylococcus aureus septicemia.Left ventricular pseudoaneurysm after isolated pericarditis as a result of Staphylococcal septicemia is very rare. A case of a very young patient is described. diagnosis is made by echocardiography. Immediate surgical resection of the pseudoaneurysm is the therapy of choice.- - - - - - - - - - ranking = 3.1936889159781keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
3/788. Intraoperative left ventricular perforation with false aneurysm formation.Two cases of perforation of the left ventricle during mitral valve replacement are described. In the first case there was perforation at the site of papillary muscle excision and this was recognized and successfully treated. However, a true ventricular aneurysm developed at the repair site. One month after operation rupture of the left ventricle occurred at a second and separate site on the posterior aspect of the atrioventricular ring. This resulted in a false aneurysm which produced a pansystolic murmur mimicking mitral regurgitation. Both the true and the false aneurysm were successfully repaired. In the second case perforation occurred on the posterior aspect of the atrioventricular ring and was successfully repaired. However, a false ventricular aneurysm developed and ruptured into the left atrium producing severe, but silent, mitral regurgitation. This was recognized and successfully repaired. The implications of these cases are discussed.- - - - - - - - - - ranking = 4keywords = aneurysm (Clic here for more details about this article) |
4/788. Visualization of mitral valve aneurysm by transesophageal echocardiography.This article describes the transesophageal echocardiographic findings in a patient with pathologically proven mitral valve aneurysm. This aneurysm probably occurred as a complication of aortic valve endocarditis. Transesophageal echocardiography showed a saccular structure attached to the left atrial side of the anterior mitral leaflet with systolic expansion and diastolic collapse, and its orifice was visualized with excellent resolution. Transesophageal echocardiography is a useful diagnostic tool for evaluation of mitral valve aneurysm.- - - - - - - - - - ranking = 3.5keywords = aneurysm (Clic here for more details about this article) |
5/788. Comparison of transesophageal to transthoracic color Doppler echocardiography in the identification of intracardiac mycotic aneurysms in infective endocarditis.We report on cases of mycotic aneurysms in a group of 14 patients with infective endocarditis, all of whom were evaluated with transthoracic (TTE) and transesophageal (TEE) color Doppler echocardiography. Four mycotic aneurysms were found, one each in the left ventricular outflow tract, the right coronary sinus of valsalva, the anterior mitral leaflet, and the atrial septum. With TTE, only three of four cases of mycotic aneurysms could be detected. Utilizing TEE, however, all were detected and their connections with the heart chambers or great vessels could be readily and clearly depicted, especially those in the atrial septum and mitral leaflet. We are of the opinion that TEE is superior to TTE in the identification and detailed analysis of mycotic aneurysms complicating infective endocarditis. In addition, we feel that echocardiography may help evaluate the progress of the disease, the location and direction of infection, and the extent of involvement of the mycotic aneurysms, providing useful information for guiding surgical intervention.- - - - - - - - - - ranking = 4.5keywords = aneurysm (Clic here for more details about this article) |
6/788. Post-infarction cardiac rupture.Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.- - - - - - - - - - ranking = 0.59684445798906keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
7/788. Potential utility of left heart contrast agents in diagnosis of myocardial rupture by 2-dimensional echocardiography.This case illustrates the use of intravenous injections of a contrast agent during 2-dimensional echocardiography in a patient with myocardial rupture after myocardial infarction. Intravenous injections of echocardiographic contrast agents may have potential use in the identification of intrapericardial hemorrhage after myocardial infarction caused by myocardial rupture or development of ventricular pseudoaneurysm.- - - - - - - - - - ranking = 0.59684445798906keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
8/788. Three ventriculoplasty techniques applied to three left-ventricular pseudoaneurysms in the same patient.A 59-year-old male patient underwent surgery for triple-vessel coronary artery disease and left-ventricular aneurysm in 1994. Four months after coronary artery bypass grafting and classical left-ventricular aneurysmectomy (with Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyde-treated pericardium patch over which an omental pedicle graft was placed. Two months later, under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later. Sternocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months after the last surgical intervention, the patient died of cerebral malignancy. Pseudoaneurysm reformation, however, had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative techniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscle flaps be strongly considered as a material for re-repair of left-ventricular aneurysms.- - - - - - - - - - ranking = 6.6779112059234keywords = aneurysm, pseudoaneurysm (Clic here for more details about this article) |
9/788. Sudden death in an adult with a small ventricular septal defect and an aneurysmal membranous septum.An apparently healthy man of 26 years of age suddenly died. He was known to have had a small ventricular septal defect and complete right bundle branch block from early childhood. At post-mortem examination the small ventricular septal defect was found associated with an aneurysm of the membranous septum. Histological examination showed a normal atrioventricular node and bundle, adjacent to the aneurysm. There was fibrous interruption at the commencement of the right bundle branch, which was considered the basis of the bundle branch block. It was also considered that the right bundle branch block was of the hereditary type and that this, rather than the aneurysm of the membranous septum, was responsible for the unexpected death.- - - - - - - - - - ranking = 3.5keywords = aneurysm (Clic here for more details about this article) |
10/788. myocardial infarction-induced ventricular aneurysm in the presence of complete left bundle branch block: a case report suggesting a new electrocardiographic diagnostic criterion.A 65-year-old man who had suffered an anterior myocardial infarction (MI) 10 years ago, complicated by a ventricular aneurysm (VA), and subsequently many years later developed complete left bundle branch block (LBBB), is described, with main emphasis on the feasibility of the electrocardiographic (ECG) diagnosis of VA in the presence of this conduction abnormality. Ventricular aneurysm in our patient was repeatedly confirmed by echocardiography over the intervening years. During the time the patient maintained normal intraventricular conduction, the ECG showed persisting ST-segment elevations in the precordial leads. After the development of LBBB, the ECG displayed accentuated ST-segment elevations in the precordial leads with predominantly negative QRS complexes, and ST elevation in V5, despite its primarily positive QRS complex. The authors extend the findings from the previous literature on the diagnosis of acute MI in patients with LBBB or right intraventricular pacing, and the concept of primary and secondary repolarization changes, to the diagnosis of VA in the presence of LBBB.- - - - - - - - - - ranking = 3keywords = aneurysm (Clic here for more details about this article) |
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