1/53. 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 = 1keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
2/53. Posterior-septal pseudo-pseudoaneurysm with limited left-to-right shunt: an unexpected easy repair.Cardiac rupture represents a fatal complication of acute myocardial infarction within the first two weeks. In exceptional cases, the postinfarction rupture of the myocardium is not transmural but remains circumscribed within the wall itself as a cavity joined to the left ventricle through a narrow neck. This finding is usually defined as pseudo-pseudoaneurysm. We report a rare case of postinfarction posterior pseudo-pseudoaneurysm of the left ventricle, perforated into the right ventricle. This unusual anatomy resulted, over a period of several years, by progressive intramural dissection of the surrounding necrotic myocardium with late formation of a large, partially fibrotic chamber, communicating either with left and right ventricles. Despite correct preoperative diagnosis was not achieved by 2D echocardiography, pulsed Doppler and contrast ventriculography, a successful surgical treatment was possible with a really good outcome.- - - - - - - - - - ranking = 6keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
3/53. Acute rupture of a left ventricular false aneurysm.Left ventricular aneurysm develop when rupture of the free ventricular wall is contained by the inflammatory surrounding tissues. These false aneurysms rupture secondarily and should be treated soon after diagnosis. The diagnosis is suggested by echocardiography and confirmed by cardiac catheterization. Immediate surgery is recommended, with good survival in most reports. The patient presented in this report had ruptured his left ventricular false aneurysm before diagnosis. He was operated and had a good initial postoperative course. He died later from a severe pulmonary infection.- - - - - - - - - - ranking = 0.13963098456727keywords = aneurysm (Clic here for more details about this article) |
4/53. Ventricular septal aneurysm: a complication of myocardial infarction.We report the case of a ventricular septal aneurysm in a patient with a previous inferior myocardial infarction. Two-dimensional echocardiography demonstrated a cystic cavity in the muscular septum with a small communication into the left ventricle. No evidence of left-to-right shunt was detected with Doppler echocardiography or during left ventriculography.- - - - - - - - - - ranking = 0.099736417548052keywords = aneurysm (Clic here for more details about this article) |
5/53. Successful repair of myocardial free wall rupture after thrombolytic therapy for acute infarction.BACKGROUND: Controversy exists regarding the timing of thrombolytic administration and rupture rate. methods: hospital records at St. Luke's-Roosevelt Hospital of the 4 study patients were reviewed and compared with those of 41 patients from a group of 537 patients concurrently admitted with a diagnosis of myocardial infarction (MI). RESULTS: Four patients experienced ventricular free wall rupture after having a MI between November 17, 1993, and July 28, 1995. All received tissue plasminogen activator. In 1 patient, pericardial effusion associated with a pseudoaneurysm was discovered in the operating room. The 3 others developed clinical pericardial tamponade before surgery. All 4 patients survived and left the hospital on postoperative days 10, 11, 11, and 82, respectively. During this same time period, 537 patients were admitted with MI, 41 of whom died; the study's 4 patients were compared with these 41. CONCLUSIONS: These data demonstrate that rupture of the ventricular free wall can occur early after thrombolytic therapy and may have a subacute course. Prompt diagnosis and surgery offer excellent chances of surviving this fatal condition.- - - - - - - - - - ranking = 1keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
6/53. Unusual form of cardiac rupture: sealed subacute left ventricular free wall rupture, evolving to intramyocardial dissecting hematoma and to pseudoaneurysm formation--a case report and review of the literature.This report describes an unusual course of rupture of the left ventricular free wall, complicating acute myocardial infarction. Spontaneous sealing of the rupture site enabled close echocardiographic follow-up, during which we monitored the development of intramyocardial dissecting hematoma and, finally, development of a full tear in the left ventricular free wall, leading to the formation of a pseudoaneurysm. The pathophysiology, management, and diagnostic criteria of these processes are being revised.- - - - - - - - - - ranking = 5keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/53. Ventricular aneurysm repair: a new approach.Repair of chronic left ventricular aneurysm or acute rupture of the heart after myocardial infarction is associated with technical difficulties and major morbidity and mortality. We describe a new endoventricular repair for both conditions. The repair consists of externally covering a Duran ring with Dacron and internally lining it with autologous pericardium. The modified ring is then sewn into the neck of the lesion. The technique is rapid, simple, and hemostatic. After repair of the chronic aneurysm, ventricular hemodynamics are improved during both diastole and systole. We have performed this technique in two patients with chronic aneurysm and one with subacute rupture.- - - - - - - - - - ranking = 0.13963098456727keywords = aneurysm (Clic here for more details about this article) |
8/53. Left ventricular pseudoaneurysm after sutureless repair of subacute left ventricular free wall rupture: a case report.A 65-year-old woman presenting with a left ventricular pseudoaneurysm 27 months after sutureless repair of a subacute left ventricular free wall rupture complicating acute myocardial infarction is described. An autologous pericardial patch and gelatin resorcin formaldehyde (GRF) glue were used in the repair. A small pseudoaneurysm bulged out over the true aneurysm of the left ventricle. We performed a Dor operation and concomitant bypass grafting to the right coronary artery. Although sutureless repair is an effective procedure for subacute left ventricular free wall rupture, left ventricular pseudoaneurysm in the late postoperative period may be a rare problem after this repair.- - - - - - - - - - ranking = 7.0199472835096keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
9/53. Transesophageal three-dimensional echocardiographic assessment of left ventricular pseudoaneurysm.We report an adult patient with a left ventricular pseudoaneurysm following an acute myocardial infarction in whom three-dimensional (3-D) transesophageal echocardiography (TEE) delineated clearly not only the location but also the size and shape of the rupture site. The size of the rupture site measured by 3-D TEE correlated well with the surgical measurements. Three-dimensional images also showed a localized superior distortion of the lateral aspect of the mitral annulus and left atrial wall produced by the pseudoaneurysm. The resulting severe mitral regurgitation practically disappeared after repair and decompression of the pseudoaneurysm.- - - - - - - - - - ranking = 7keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
10/53. Left ventricular pseudoaneurysm caused by coronary spasm, myocardial infarction, and myocardial rupture.We report a very rare case of a 47-year-old man who had coronary spasm that resulted in a silent myocardial infarction, a ruptured myocardial wall, and a nonruptured left ventricular pseudoaneurysm. The patient presented with a 6-month history of dyspnea on exertion, without evidence of fixed coronary artery stenosis. coronary angiography showed severe coronary spasm of the left anterior descending and left circumflex arteries; the spasm was relieved promptly by nitroglycerin. echocardiography and left ventricular angiography revealed the large left ventricular pseudoaneurysm posterolateral to the left ventricle. We performed surgical resection of the pseudoaneurysm and patch repair of the ruptured left ventricular wall, with excellent results. We present this case because of the highly unusual sequence of events. Early surgical intervention resulted in the patient's recovery.- - - - - - - - - - ranking = 7keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
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