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1.
No Shinkei Geka ; 48(1): 25-32, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31983685

RESUMO

Intracranial pseudoaneurysms arising after radiotherapy for brain tumors are a relatively rare occurrence and associated with high-volume radiotherapy such as stereotactic radiosurgery. Herein, the authors report a rare case of intracranial pseudoaneurysm after conventional radiotherapy for oligodendroglioma. Case:A 46-year-old female incidentally presented with an intracranial hemorrhage from a middle temporal artery aneurysm. Four years earlier, she underwent surgical resection and conventional radiation therapy for oligodendroglioma. The aneurysm was successfully treated with middle cerebral artery(MCA)aneurysm trapping, in conjunction with a parietal branch superficial temporal artery-MCA bypass, to prevent re-rupture. Formation of intracranial pseudoaneurysm after conventional radiotherapy is extremely rare. However, the occurrence of cerebral aneurysm(s), as well as vascular stenosis during follow-up for brain tumors treated with radiotherapy, should be considered.


Assuntos
Falso Aneurisma , Neoplasias Encefálicas , Aneurisma Intracraniano , Oligodendroglioma , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Neoplasias Encefálicas/radioterapia , Angiografia Cerebral , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/etiologia , Pessoa de Meia-Idade , Artéria Cerebral Média , Oligodendroglioma/radioterapia , Artérias Temporais
2.
No Shinkei Geka ; 48(1): 39-45, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31983687

RESUMO

We herein report a case of ruptured arterio-venous malformation(AVM)detected using three-dimensional digital subtraction angiography(3DDSA)fusion images and successfully treated with target embolization for pseudoaneurysm. A 50-year-old man with a history of AVM was admitted to our department for the treatment of ruptured high-grade AVM in the right parietal lobe. Although a bleeding point was not evident on DSA, the patient had re-rupture in the right ventricle, one month after admission. Chronological 3DDSA fusion images generated from 3DDSA images taken on admission and after re-rupture revealed a newly visualized intranidal pseudoaneurysm near a hematoma. Contrast-enhanced magnetic resonance imaging showed vessel wall enhancement along the posterior horn of the right ventricle;this enhancement corresponded to the location of the pseudoaneurysm. We planned target embolization for the intranidal pseudoaneurysm to prevent re-bleeding. The origin of the feeder was so steep that a microcatheter could not be advanced deeply, and embolization with 20% n-butyl-2-cyanoacrylate resulted in proximal occlusion. Follow-up angiography 1 week after embolization showed complete disappearance of the pseudoaneurysm, and the patient had no recurrence of aneurysm until one year.


Assuntos
Falso Aneurisma , Aneurisma Roto , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Aneurisma Roto/diagnóstico , Aneurisma Roto/terapia , Angiografia Digital , Humanos , Imagem Tridimensional , Malformações Arteriovenosas Intracranianas/diagnóstico , Malformações Arteriovenosas Intracranianas/terapia , Masculino , Pessoa de Meia-Idade
3.
Vasc Endovascular Surg ; 54(1): 42-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31578127

RESUMO

OBJECTIVE: In clinical practice, the incidence of femoral pseudoaneurysms requiring repair is small, but at a tertiary care center, the repair rate is higher due to referrals. We sought to specifically study patients who suffered postcatheterization pseudoaneurysms requiring thrombin injection or operative repair and compare them to our routine transfemoral endovascular patients to identify predictors of clinically significant pseudoaneurysms. The underlying goal would be to identify what makes these patients that develop pseudoaneurysms different. METHODS: A search of our billing records for Current Procedural Technology (CPT) codes of these 2 procedures between January 2008 and April 2018 was combined with our institution's Peripheral Vascular Intervention Vascular Quality Initiative database spanning from January 2013 to December 2017. A comparison was then performed between patients who had the outcome of operative intervention for a pseudoaneurysm complication and those who did not, with the goal of elucidating patient demographics and periprocedural factors that would predict pseudoaneurysm formation using univariate and multivariate analyses. RESULTS: There were 77 patients who required thrombin injection or open repair for access-related pseudoaneurysms and 324 patients who did not. Complications occurred more often in patients who were older than 75 (40.2% vs 21.9%; P = .0009), female (57.1% vs 38.6%; P = .003), obese (59.7% vs 33.3%; P < .001), hypertensive (96.1% vs 79.3%; P = .0005), who received a sheath >6F (32.4% vs 13%; P < .0001), intraoperative and postoperative anticoagulation (77.3% vs 32.7% and 52.1% vs 24.2%, respectively; P < .0001), and periprocedural P2Y12 inhibitors (48.7% vs 28%; P = .0005). Less complications were observed in patients who had a closure device used (42.9% vs 8.45%; P < .0001) and protamine reversal (26.5% vs 13.3%; P = .0163). CONCLUSIONS: Our findings validate published reports that incriminate a larger sheath size, perioperative anticoagulation, and female gender as increasing the rate of access site complications, with the use of a closure device being protective.


Assuntos
Falso Aneurisma/etiologia , Cateterismo Periférico/efeitos adversos , Artéria Femoral/lesões , Virilha/irrigação sanguínea , Lesões do Sistema Vascular/etiologia , Demandas Administrativas em Assistência à Saúde , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Bases de Dados Factuais , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Illinois , Injeções , Masculino , Estudos Retrospectivos , Fatores de Risco , Trombina/administração & dosagem , Fatores de Tempo , Procedimentos Cirúrgicos Vasculares , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/terapia
4.
Rev. cuba. angiol. cir. vasc ; 20(2): e391, jul.-dic. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1003861

RESUMO

Introducción: Los aneurismas arteriales son poco frecuentes en edad pediátrica, sin embargo; se observa un incremento en la incidencia de pseudoaneurismas a partir de traumatismos vasculares, sobre todo, por la aplicación de procederes invasivos. También se observan en procesos infecciosos y tumorales adyacentes, que acaban por lesionar la pared arterial. La mayoría suelen ser asintomáticos, o se presentan como una masa pulsátil que se asientan sobre la zona de la arteria afectada. Objetivo: Demostrar la importancia del diagnóstico temprano de los pseudoaneurismas para el tratamiento quirúrgico oportuno y evitar complicaciones posteriores. Presentación del caso: se discute un caso de una paciente de dos años de edad con un trauma vascular iatrogénico en la extremidad inferior derecha, que se manifestó como una tumoración pulsátil. Se realizó eco-doppler y angiografía, con lo que se diagnosticó un aneurisma de la arteria femoral derecha. Se realizó una exéresis y reconstrucción vascular con buena evolución. Conclusiones: El diagnóstico rápido de estas entidades vasculares evita que se presenten complicaciones posteriores y aseguran una evolución rápida y satisfactoria de los pacientes que las padecen(AU)


Introduction: Arterial aneurysms are rare in the pediatric ages. However, it is observed an increasement of the incidence of pseudoaneurysms caused by vascular traumas, mainly due to the use of invasive procedures. It is also present in infectious and tumour processes that end up injuring the arterial wall. Most of them are asymptomatic or are presented as a pulsatile mass that sets up over the affected artery's zone. Objective: To show the importance of early diagnosis of pseudo-aneurysms. Case presentation: It is presented the case of a two years old patient with a iatrogenic vascular trauma in the right lower limb that manifested in the way of a pulsatile tumor. Through an eco-Doppler and an angiography, an aneurysm of the right femoral artery was diagnosed, which led to an excision and a vascular reconstruction with good evolution. Conclusions: Early diagnosis of these vascular entities allows its timely surgical treatment, avoids the appearance of further complications and assures a prompt and satisfactorily evolution of the patients(AU)


Assuntos
Humanos , Feminino , Pré-Escolar , Falso Aneurisma/cirurgia , Falso Aneurisma/diagnóstico , Artéria Femoral , Angiografia por Tomografia Computadorizada/métodos
5.
Nihon Shokakibyo Gakkai Zasshi ; 116(9): 754-763, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31511462

RESUMO

A 51-year-old woman underwent endoscopic biliary drainage with a plastic stent for obstructive jaundice due to unresectable pancreatic head cancer. During chemotherapy following heavy ion therapy for the cancer, she presented with acute cholangitis and massive rectal bleeding. The massive hemorrhage was caused by rupture of the biliary duct due to a pseudoaneurysm in the right hepatic artery. The position of the aneurysm coincided with the liver-side end of the plastic stent. Sustained irritation of the arterial and bile duct walls by the stent was considered to have contributed to formation of the aneurysm.


Assuntos
Falso Aneurisma/diagnóstico , Icterícia Obstrutiva/cirurgia , Neoplasias Pancreáticas/cirurgia , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Artéria Hepática , Humanos , Pessoa de Meia-Idade , Plásticos , Stents
6.
J Med Case Rep ; 13(1): 239, 2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31375131

RESUMO

BACKGROUND: Pseudoaneurysm of thoracic aorta as a complication of blunt trauma to the chest, can present with a variety of symptoms due to mass compression effect. Here we report the first pseudoaneurysm of thoracic aorta presenting with chronic cough and inappropriate sinus tachycardia. The purpose of this case report is to highlight pseudoaneurysm of thoracic aorta as a rare differential diagnosis for inappropriate sinus tachycardia. CASE PRESENTATION: Here we report a case of 29-year-old white woman, a nurse, with history of a motor vehicle accident. She initially presented to medical attention with inappropriate sinus tachycardia 2 years following the motor vehicle accident during her pregnancy. Six years later she underwent sinoatrial node modification after failing a number of medications. Days prior to the ablation she developed a mild cough which became constant within a week following ablation. A computed tomography scan of her chest performed as part of a workup revealed an outpouching of the inferomedial aspect of the aortic arch, which was compressing her left main bronchus. She underwent arch repair surgery and recovered without complications. Four years later she presented with significant symptomatic sinus bradycardia requiring pacemaker placement. CONCLUSIONS: This is the first reported case of thoracic pseudoaneurysm of aorta presenting with inappropriate sinus tachycardia due to compression of the vagal nerve and cough as a result of the left main bronchus compressive effect; it highlights the importance of considering structural abnormalities in a differential diagnosis of inappropriate sinus tachycardia before any interventions.


Assuntos
Falso Aneurisma/diagnóstico , Nó Sinoatrial/anormalidades , Adulto , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/inervação , Angiografia por Tomografia Computadorizada , Tosse/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Nó Sinoatrial/diagnóstico por imagem , Nó Sinoatrial/cirurgia , Taquicardia Sinusal/diagnóstico
7.
World Neurosurg ; 131: 163-165, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31376557

RESUMO

BACKGROUND: Vascular complications during transsphenoidal surgery can be devastating. Direct vascular injury during surgery can lead to various complications including pseudoaneurysm formation. Postoperative hematoma and direct vascular handling due to arachnoid tear can induce vasospasm. The vasospasm might present with varying clinical symptomatology and at times masks the underlying pathology as well. CASE DESCRIPTION: We present here a case of pituitary macroadenoma in whom the vasospasm caused vision loss and also concealed a developing pseudoaneurysm. CONCLUSIONS: Angiograms at regular intervals should be performed in cases where intraoperative vascular injury is suspected to detect such aneurysms and prevent catastrophe.


Assuntos
Adenoma/cirurgia , Falso Aneurisma/diagnóstico , Cirurgia Endoscópica por Orifício Natural , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/diagnóstico , Vasoespasmo Intracraniano/diagnóstico , Adenoma/complicações , Adulto , Falso Aneurisma/etiologia , Angiografia Cerebral , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hipofisárias/complicações , Vasoespasmo Intracraniano/etiologia
8.
Medicine (Baltimore) ; 98(28): e16442, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305471

RESUMO

RATIONALE: Visceral arterial pseudoaneurysms are rare but important vascular entities because of their inclination to cause life-threatening hemorrhage. They were commonly reported to be associated with trauma, infection, inflammatory disease, or occurred as postoperative complication. To date, there has been no published report of a superior mesenteric artery (SMA) branch pseudoaneurysm rupture mimicking acute pancreatitis in a patient with acute type B aortic dissection. PATIENT CONCERNS: The patient's medical history, clinical information, imaging findings including follow-up computed tomography angiography (CTA), and treatment are reported. A 51-year-old male presenting with epigastric pain and fever was found to have an enlarged pancreatic head and obscure fatty space around it on abdominal nonenhanced CT. He has medical history of anaphylactoid purpura and uncontrolled hypertension. His serum lipase and amylase were both within normal limits. Thoracoabdominal CTA following a sudden blood pressure drop attributed to the accurate diagnosis. DIAGNOSES: He was diagnosed with acute type B aortic dissection involving SMA and retroperitoneal hemorrhage secondary to SMA branch pseudoaneurysm rupture. INTERVENTIONS: The patient was successfully treated by thoracic endovascular aortic repair without additional branch intervention. OUTCOMES: Follow-up CTA at 3 months later demonstrated that the endoprothesis is well positioned with no endoleaks, and SMA branch pseudoaneurysm disappeared. LESSONS: We report a rare and complicated case presenting with SMA branch pseudoaneurysm rupture and acute type B aortic dissection. CTA is vital in the diagnosis of such vessel pathology. We must inspect carefully to ensure that no small lesions are missed.


Assuntos
Aneurisma Dissecante/diagnóstico , Falso Aneurisma/diagnóstico , Aneurisma Roto/diagnóstico , Aneurisma Aórtico/diagnóstico , Artéria Mesentérica Superior , Aneurisma Dissecante/complicações , Aneurisma Dissecante/cirurgia , Falso Aneurisma/complicações , Falso Aneurisma/cirurgia , Aneurisma Roto/complicações , Aneurisma Roto/cirurgia , Aneurisma Aórtico/complicações , Aneurisma Aórtico/cirurgia , Diagnóstico Diferencial , Humanos , Masculino , Artéria Mesentérica Superior/diagnóstico por imagem , Pessoa de Meia-Idade , Pancreatite/diagnóstico
9.
Int Heart J ; 60(4): 998-1002, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31257334

RESUMO

Ventricular pseudoaneurysm (PSA) is a rare, yet life-threatening complication of myocardial infarction, cardiac surgery, and transcatheter valve replacement. Although conventional surgery is the preferred treatment strategy, transcatheter closure has emerged as an effective alternative in selected candidates. In this report, we describe successful transcatheter closure of two unique cases of ventricular pseudoaneurysm (PSA): first, a complex post-myocardial infarction left ventricular PSA (LVPSA) with multi-communications, and second, a case of post-traumatic right ventricular PSA (RVPSA) following blunt chest injury caused by domestic violence.


Assuntos
Falso Aneurisma/cirurgia , Cateterismo Cardíaco/métodos , Aneurisma Cardíaco/cirurgia , Ventrículos do Coração , Infarto do Miocárdio/complicações , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Idoso , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Procedimentos Cirúrgicos Cardíacos/métodos , Violência Doméstica , Ecocardiografia , Feminino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/etiologia , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Traumatismos Torácicos/diagnóstico , Ferimentos não Penetrantes/diagnóstico
11.
Ann R Coll Surg Engl ; 101(7): e154-e156, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31155912

RESUMO

Infected pseudoaneurysms are a vascular emergency, necessitating urgent surgical management. Owing to the infected field, a synthetic graft may be inappropriate in patients for whom autografting is impossible. Ligation of the artery is the usual management, often leading to amputation. We report a case of cadaveric allografting of the common femoral artery in a patient with a traumatic, infected pseudoaneurysm, who was taking immunosuppressive therapy for a liver transplant. The patient was followed up with ultrasound at 12 months and was found to have a significant graft stenosis, which was treated successfully with angioplasty. At 18 months, the patient remained well. This case describes the successful implantation of a cadaveric allograft into a patient with an infected pseudoaneurysm, negating the for need primary ligation.


Assuntos
Falso Aneurisma/cirurgia , Veia Femoral/transplante , Flebotomia/efeitos adversos , Infecções Estafilocócicas/cirurgia , Enxerto Vascular/métodos , Adulto , Aloenxertos/transplante , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Falso Aneurisma/microbiologia , Cadáver , Angiografia por Tomografia Computadorizada , Artéria Femoral/cirurgia , Veia Femoral/diagnóstico por imagem , Veia Femoral/lesões , Veia Femoral/microbiologia , Virilha , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Resultado do Tratamento
12.
Am J Trop Med Hyg ; 101(1): 157-159, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162010

RESUMO

Intrahepatic pseudoaneurysm (IHPA) is generally iatrogenic, and it warrants urgent management because of its reportedly significant risk of rupture leading to considerable mortality. Intrahepatic pseudoaneurysm caused by amebic liver abscess (ALA) is exceedingly rare with fewer than seven published reports. All reported symptomatic cases have been treated with hepatic artery embolization; therefore, little is known about its natural course and effect of abscess drainage on its outcome. We report the first case of symptomatic intracavitary IHPA caused by ALA in which ultrasound-guided percutaneous catheter drainage of the abscess resulted in the spontaneous resolution of the IHPA.


Assuntos
Falso Aneurisma/etiologia , Drenagem , Artéria Hepática/patologia , Abscesso Hepático Amebiano/complicações , Abscesso Hepático Amebiano/terapia , Falso Aneurisma/diagnóstico , Falso Aneurisma/patologia , Humanos , Masculino , Pessoa de Meia-Idade
13.
Khirurgiia (Mosk) ; (5): 68-70, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31169822

RESUMO

The patient 58-year-old with nodular goiter grade 2 was hospitalized to the surgical clinic. Thyroidectomy was performed. Postoperative period was complicated by hiccups and pulsation in the right half of the neck. According to angiography and CT data, there were a hematoma within thyroid bed and arteriovenous fistula between superior thyroid artery and right facial vein. Surgical repair of the fistula and false aneurysm drainage were carried out. This case report demonstrates a rare complication of thyroidectomy - arteriovenous fistula between superior thyroid artery and facial vein followed by pulsatile false aneurysm.


Assuntos
Falso Aneurisma/cirurgia , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Externa/cirurgia , Bócio Nodular/cirurgia , Tireoidectomia/efeitos adversos , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Angiografia , Fístula Arteriovenosa/etiologia , Lesões das Artérias Carótidas/diagnóstico , Lesões das Artérias Carótidas/etiologia , Face/irrigação sanguínea , Humanos , Pessoa de Meia-Idade , Glândula Tireoide/irrigação sanguínea , Glândula Tireoide/cirurgia
15.
Heart Surg Forum ; 22(3): E252-E255, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31237553

RESUMO

Anastomotic pseudoaneurysm remains one of the main life-threatening complications of cardiac and thoracic aorta surgery. We report a rare case of infected pseudoaneurysm at the anastomotic line found during follow-up. Blood culture results suggested Enterococcus faecium infection. Transthoracic echocardiography and computed tomography scans revealed the presence of a pseudoaneurysm of the ascending aorta. The pseudoaneurysm was resected and the ascending aorta was reconstructed with an artificial vascular patch without complications. Reducing the anastomotic tension, with complete hemostasis at the anastomotic incision, is the most important means of preventing the formation of pseudoaneurysm.


Assuntos
Falso Aneurisma/etiologia , Aneurisma Infectado/etiologia , Estenose da Valva Aórtica/cirurgia , Enterococcus faecium , Infecções por Bactérias Gram-Positivas/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Adulto , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/terapia , Feminino , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/terapia , Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia
16.
Tex Heart Inst J ; 46(2): 143-146, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31236083

RESUMO

A 63-year-old woman was incidentally found to have a thoracic aortic aneurysm. We performed hybrid repair involving aortic arch debranching and endovascular stent-graft placement. Four months later, an asymptomatic pseudoaneurysm had formed at the aortic conduit-brachiocephalic artery anastomosis. To exclude the pseudoaneurysm, we deployed a Covered CP Stent across the anastomosis through a surgically created right axillary artery conduit. We discuss the patient's case and our choice of treatment.


Assuntos
Falso Aneurisma/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Tronco Braquiocefálico/cirurgia , Materiais Revestidos Biocompatíveis , Procedimentos Endovasculares/métodos , Stents , Falso Aneurisma/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico , Aortografia , Tronco Braquiocefálico/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Pessoa de Meia-Idade , Desenho de Prótese
17.
Tex Heart Inst J ; 46(2): 147-150, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31236084

RESUMO

Pseudoaneurysms of the mitral-aortic intervalvular fibrosa are rare complications that can develop after mitral or aortic valve surgery, endocarditis, or Takayasu arteritis. The optimal timing of surgery to avoid potentially life-threatening complications of pseudoaneurysms has not been established, and watchful waiting has been adopted in specific situations. We describe the case of a 50-year-old man in whom a pseudoaneurysm of the mitral-aortic intervalvular fibrosa developed after aortic root replacement with a homograft. After 13 years of watchful waiting, reoperation was deemed necessary because the pseudoaneurysm had grown to 48 mm and the aortic regurgitation caused by the degenerated homograft had become severe. This case highlights the need for increased awareness of mitral-aortic intervalvular fibrosa pseudoaneurysms and their management.


Assuntos
Falso Aneurisma/cirurgia , Aorta Torácica/cirurgia , Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Aneurisma Cardíaco/cirurgia , Valva Mitral/cirurgia , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Aorta Torácica/diagnóstico por imagem , Insuficiência da Valva Aórtica/cirurgia , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Imagem Tridimensional , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Reoperação , Tomografia Computadorizada por Raios X
20.
J Cardiothorac Surg ; 14(1): 93, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101055

RESUMO

BACKGROUND: Left ventricular (LV) pseudo-false aneurysm is a rare complication secondary to myocardial infarction and is caused by intramyocardial dissecting hematoma due to fragile myocardium. Very occasionally, intramyocardial dissecting hematoma appears as a neocavitation entirely contained within the myocardial wall (so called "pseudo-false LV") and is an unusual form of subacute cardiac rupture. CASE PRESENTATION: A 38-year-old male experienced chest discomfort 3 weeks ago, which improved within few days. However, after that episode, he presented at our hospital with rapidly deteriorating severe breathlessness in a preshock state with acute heart failure. Emergency coronary angiography revealed an occluded left anterior descending artery. An intra-aortic balloon catheter was inserted because of unstable hemodynamics. Enhanced computed tomography revealed extensive aneurysm formation in the LV anterior wall and contrast leakage from the inner cavity to the LV myocardium, with a moderately accumulated pericardial effusion. Emergency surgery revealed a large aneurysmal sac on the anterior wall, slightly attached to the pericardium. A 5-mm, slit-like, oozing-type, rupture site was detected in the LV after dissecting the pericardium. CONCLUSIONS: To our knowledge, this is the first report of a pseudo-false aneurysm on the LV anterior wall. Subacute rupture of pseudo-false LV aneurysm is rare.


Assuntos
Falso Aneurisma/diagnóstico , Aneurisma Roto/diagnóstico , Infarto Miocárdico de Parede Anterior/diagnóstico , Aneurisma Cardíaco/diagnóstico , Ventrículos do Coração , Adulto , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Infarto Miocárdico de Parede Anterior/complicações , Infarto Miocárdico de Parede Anterior/diagnóstico por imagem , Infarto Miocárdico de Parede Anterior/cirurgia , Angiografia Coronária , Diagnóstico Diferencial , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/cirurgia , Humanos , Masculino
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