Cases reported "Heart Injuries"

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1/36. 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.
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ranking = 1
keywords = aneurysm
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2/36. Cardiac and great vessel injuries in children after blunt trauma: an institutional review.

    PURPOSE: The purpose of this study was to review the incidence of cardiac and great vessel injury after blunt trauma in children. METHOD: A retrospective review of 2,744 patients with injuries from blunt mechanisms was performed. RESULTS: Eleven patients sustained cardiac injury. Four patients had clinically evident cardiac contusions. All recovered. Four patients who died from central nervous system injury were found to have cardiac contusions at autopsy. None had clinical evidence of contusion before demise. One patient had a traumatic ventricular septal defect (VSD) that required operative repair. autopsy findings showed a VSD in another patient, and a third patient was found to have a ventricular septal aneurysm that was treated medically. Two patients had great vessel injuries. One patient had a contained disruption of the superior vena cava that was managed nonoperatively. Another patient had a midthoracic periaortic hematoma without intimal disruption found at autopsy. One patient had cardiac and great vessel injuries. Discrete aneurysms of 2 coronary artery branches and the pulmonary outflow tract were identified by cardiac catheterization. This patient was treated nonoperatively. CONCLUSIONS: Cardiac and great vessel injury after blunt trauma are uncommon in children. Cardiac contusion was the most common injury encountered but had minimal clinical significance. Noncontusion cardiac injury is rare. No patient with aortic transection was identified.
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ranking = 0.25
keywords = aneurysm
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3/36. Pseudoaneurysm of the right ventricular outflow tract complicating balloon dilatation for tetralogy of fallot.

    Balloon dilatation is one of the treatment options in symptomatic infants with tetralogy of fallot and hypoplastic pulmonary annulus and pulmonary artery. A balloon dilatation was performed on a 28-day-old infant with tetralogy of fallot with an appropriate balloon. The patient developed two pseudoaneurysms on the right ventricular outflow tract after the procedure which were diagnosed when the patient was admitted for total correction at 20 months of age. This case demonstrates an unusual but potentially life-threatening long-term complication of this procedure.
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ranking = 0.81758561449116
keywords = pseudoaneurysm, aneurysm
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4/36. Unusual manifestations of penetrating cardiac injuries.

    Penetrating cardiac injuries frequently first appear in an unusual and insidious manner, and their diagnosis may not be immediately obvious. In a series of 20 cases of cardiac injury, ten cases were indicative of such subtle symptoms, several of which were life-threatening. These unusual manifestations can be categorized as early, intermediate, or late. Early problems of four patients included the following: (1) sudden onset of shock during laparotomy, performed due to apparent abdominal trauma; (2) cardiac arrest on arrival in the emergency room; and (3) cerebral air embolus and mimicked symptoms of possible irreversible anoxic brain damage. The intermediate manifestations of cardiac injury are usually discovered in the early recovery period, and include myocardial infarction with cardiogenic shock and bullet embolus to a peripheral artery. Intermediate manifestations were observed in two patients. Four patients had late complications that included pseudoaneurysm, ventricular septal defect, valvular damage, and recurrent pericarditis. These late complications were observed between one month and 21 years after cardiac injury. This indicates the necessity of long-term follow-up of these patients.
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ranking = 0.31758561449116
keywords = pseudoaneurysm, aneurysm
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5/36. Traumatic coronary artery dissection.

    A 14-year-old boy sustained blunt chest trauma resulting in dissection of the left main coronary artery, postinfarction left ventricular aneurysm, mitral regurgitation, and tricuspid regurgitation. He underwent pericardial patch angioplasty of the left main coronary artery, left ventricular aneurysmectomy, mitral valvuloplasty, and tricuspid annuloplasty. The patient continues to do well 4 years after operation.
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ranking = 0.25
keywords = aneurysm
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6/36. Myocardial contusion culminating in a ruptured pseudoaneurysm of the left ventricle--a case report.

    Blunt chest trauma continues to be one of the most common injuries at all ages. Trauma in general is the leading cause of death in the young to middle-aged segment of our population. Blunt chest injury is said to occur in more than one third of all motor vehicle accidents. Myocardial contusion is the most frequent cardiac injury resulting from blunt chest trauma. autopsy studies indicate that cardiac trauma was directly associated with death in approximately 10% of cases suffering blunt chest injury. aneurysm formation as a sequela of blunt cardiac trauma is a rare entity and pseudoaneurysm formation is considerably more rare. A case of myocardial contusion resulting in myocardial necrosis, rupture of the ventricle, and pseudoaneurysm formation with subsequent rupture and sudden death is presented.
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ranking = 1.905513686947
keywords = pseudoaneurysm, aneurysm
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7/36. Delayed presentation of left ventricular outflow tract aneurysm after penetrating cardiac trauma.

    We report a case of posttraumatic left ventricular outflow tract aneurysm in a patient who had a stab injury to the chest requiring emergency operation 40 years previously. After apparent decades without symptoms, the patient presented with exertional dyspnea. Clinical and echocardiographic assessment revealed aortic regurgitation and left ventricular outflow tract aneurysm. Injuries to the chest wall that penetrate the heart and great vessels are life-threatening and require emergency operative intervention. However, these injuries rarely, as in this case, result in chronic cardiac aneurysm and aortic valvular incompetence.
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ranking = 0.875
keywords = aneurysm
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8/36. A case of takotsubo-shaped hypokinesis of the left ventricle caused by a lightning strike.

    A 62-year-old woman was struck by lightning while on a mountain and fortunately did not suffer burns or unconsciousness. She stayed at a mountain lodge overnight and was taken to our hospital by helicopter the next day. Upon admission, electrocardiography showed ST segment elevation indicating acute lateral myocardial infarction, and echocardiography showed takotsubo-shaped hypokinesis of the left ventricle indicating an apical aneurysm. Her serum escaped enzyme levels were increased, as is typical in cases of myocardial infarction, however, she did not complain of cardiac symptoms. Coronary arteriography performed 4 days after admission showed a normal coronary artery while left ventriculography showed apical akinesia. An echocardiogram obtained 2 days later showed resolution of the LV wall motion abnormality. This is the first reported case of takotsubo cardiomyopathy caused by lightning. Takotsubo-shaped hypokinesis is not described as a complication of lightning-induced cardiac injury and its pathogenesis remains controversial.
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ranking = 0.125
keywords = aneurysm
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9/36. Combination of traumatic thoracic aortic pseudoaneurysm and myocardial contusion leading to left ventricular aneurysm.

    The combination of thoracic aortic pseudoaneurysm and left ventricular aneurysm resulting from a single traumatic incident is an exceedingly rare occurrence. We present a case of a 10-year-old girl who sustained significant blunt trauma to the chest after being involved in a rollover motor vehicle accident. The child underwent immediate repair of a transected aortic arch. An inferior wall left ventricular aneurysm developed 3 weeks later, and the patient underwent successful repair of the left ventricular aneurysm and a damaged mitral valve. The use of fast multidetector row CT, cardiac MRI, and echocardiography have improved our ability to diagnose these types of injuries and accurately image their anatomic relationships in the acute and perioperative settings.
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ranking = 2.4629280724558
keywords = pseudoaneurysm, aneurysm
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10/36. Double aneurysm of the left ventricular wall following cardiac perforation after aortic valvuloplasty.

    In this report we present the case of a double aneurysm, which developed 1 week after pericardiocentesis because of cardiac perforation following aortic valvuloplasty in a newborn. The patient underwent successful surgical treatment through normothermic cardiopulmonary bypass with external plication of double aneurysm.
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ranking = 0.75
keywords = aneurysm
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