scholarly journals Pseudoaneurysm of interventricular membranous septum: a rare late complication after repeated valve replacements

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 152
Author(s):  
Ferhat Piskin ◽  
Rabia Akilli ◽  
Umur Pehlivan ◽  
Erol Aksungur ◽  
Kairgeldy Aikimbaev

A 39-year-old female patient who had aortic and mitral valve replacement due to rheumatic heart disease was also found to have cystic mass in the right ventricle on echocardiography during late routine control. The cystic mass identified on echocardiography was shown to be a pseudoaneurysm that develops from the membranous section of the interventricular septum and grows toward the right heart by ECG-triggered cardiac computed tomography performed for differential diagnosis. Because the patient did not accept the surgery, regular follow-ups were recommended.

Perfusion ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 170-172
Author(s):  
Mosaad El Banna ◽  
Luis Geraldes ◽  
Julia Grapsa ◽  
Cristiana Ramalhao ◽  
Santhi Adigopula ◽  
...  

A 90-year-old female patient presented to the emergency department with abdominal pain. Computed tomography (CT) set the suspicion of a cardiac tumor in the right heart chambers. We describe the presentation, the differential diagnosis and the decision for management of the patient.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jouan ◽  
I Masari ◽  
V Bliah ◽  
G Soulat ◽  
D Craiem ◽  
...  

Abstract Introduction In order to improve knowledge of the tricuspid valve (TV) function and its coupling with the right atrio-ventricular junction (RAVJ) and right ventricle (RV), new four-dimensional high-definition imagery methods are mandatory (3D+t). Purpose Using an innovative reconstruction method based on multiphase cardiac computed tomography imaging (4D-MCCTI), we finely analyzed the morphological & dynamical features of tricuspid annulus (TA) and RAVJ components in order to assess new functional parameters of TV and RV functions. Methods Volume imaging data sets through time were obtained from 4D-MCCTI of 30 subjects (sex ratio 1, mean age 57±11y.) with no rhythm, valvular or ventricular abnormalities on echocardiography and implemented in a custom software for 3D semi-automated delineation of 18 points around TA perimeter. Coordinates of these points in each of the 10 time-phases within an RR interval were used to calculate specific geometrical features of TA such as 3D/2D areas, perimeters, 360°-diameters and vertical deformation. Subsequently, RV and Right Atrium (RA) inner contours were also delineated (Figure). Results TA shape was elliptical in horizontal projection with a mean eccentricity index (EcI) of 0.58±0.12; and saddle-shapped in vertical projection with a horn nearby the antero-septal commissure. This feature remained throughout the cardiac cycle but TA was more planar (minimal TA-height: 4.47±1.04 mm) and circular (minimal EcI=0.44±0.14) in mid-diastole when TA-3Darea and TA-3Dperimeter reached a maximum of 6.98±1.21 cm2/m2 and 7.41±0.91 cm, respectively. Correlation between TA-3Darea, TA-2Darea and latero-septal diameter (LSD) were R2=0.99 and R2=0.73, respectively. LSD was minimal in early-systole (18.83±3.04 mm/m2) and maximal in mid-diastole (20.04±3.05 mm/m2). Correlation of TA-3Darea with RV and RA cross-sectional areas were R2=0.82 and R2=0.71, respectively. Conversely, there was no significant correlation between TA, RV and RA concentric contractions. Conclusions Our method for 4D-MTCCI analysis has allowed confirming the shape and dynamics function of RAVJ throughout the cardiac cycle in healthy subjects, and giving new reference parameters for TV and RV evaluation. Software multiplanar view of TA Funding Acknowledgement Type of funding source: None


2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Nina P. Hofmann ◽  
Hassan Abdel-Aty ◽  
Stefan Siebert ◽  
Hugo A. Katus ◽  
Grigorios Korosoglou

Annuloaortic ectasia is a relatively rare diagnosis. Herein, we report an unusual case of an annuloaortic ectasia with asymmetric dilatation of the right coronary bulb mimicking a membranous ventricular septal defect (VSD) with Eisenmenger reaction by transthoracic echocardiography. Aortic angiography showed a dilated aortic root and moderate aortic regurgitation. Right cardiac catheterization, on the other hand, exhibited normal pulmonary artery blood pressure and normal pulmonary resistance, whereas normal venous gas values were measured throughout the caval vein and the right atrium, excluding relevant left-right shunting. Further diagnostic workup by cardiac computed tomography angiography (CCTA) unambiguously illustrated the asymmetric geometry of the ectatic aortic cusp and root causing compression of the right heart and of the right ventricular (RV) outflow tract. After review of echocardiographic acquisitions, the blood flow detected between the left and right ventricles (mimicking VSD) was interpreted as turbulent inflow from the left ventricle into the ectatic right coronary cusp. Furthermore, elevated pulmonary artery blood pressure measured by echocardiography was attributed to “functional pulmonary stenosis” due to compression of the RV outflow tract by the aorta, as demonstrated by CCTA.


2021 ◽  
Vol 5 (4) ◽  
pp. 468-469
Author(s):  
Joshua Livingston ◽  
Savannah Gonzales ◽  
Mark Langdorf

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.


2011 ◽  
Vol 56 (No. 6) ◽  
pp. 302-306
Author(s):  
K. Lee ◽  
H. Furuoka ◽  
N. Sasaki ◽  
M. Ishii ◽  
H. Inokuma ◽  
...  

We describe the case of a nine-day-old female Holstein calf which had cheiloschisis, a moderate dome-shaped head, ataxia and opisthotonus since birth. No significant findings except the dome-shaped head were observed on survey radiography of the skull. Computed tomography (CT) images showed bilateral lateral ventriculomegaly, cerebellar hypoplasia and a cyst-like lesion communicating with the right lateral ventricle. Post-mortem examination revealed a cerebral defect in the frontoparietal lobe, which communicated with the right lateral ventricle, and cerebellar hypoplasia. CT provided a characteristic finding of porencephaly and was helpful for diagnosing the accompanying anomalies. We suggest that porencephaly should be included as a specific anomaly in the differential diagnosis of congenital brain malformation.  


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Qing-Qing Dong ◽  
Wen-Yi Yang ◽  
Ya-Ping Sun ◽  
Qian Zhang ◽  
Guang Chu ◽  
...  

Abstract Background Transesophageal echocardiography may be used to assess pulmonary veins for atrial fibrillation ablation. No study focused on the role of transthoracic echocardiography (TTE) in evaluating the diameter and anatomy of pulmonary veins. Methods Among 142 atrial fibrillation patients (57.7% men; mean age, 60.5) hospitalised for catheter ablation, we assessed pulmonary veins and compared the measurements by TTE with cardiac computed tomography (CT) before ablation. Among 17 patients who had follow-up examinations, the second measurements were also studied. Results TTE identified and determined the diameters of 140 (98.6%) right and 140 (98.6%) left superior PVs, and 136 (95.7%) right and 135 (95.1%) left inferior PVs. A separate middle PV ostia was identified in 14 out of the 22 patients (63.6%) for the right side and in 2 out of 4 (50.0%) for the left side. The PV diameters before ablation assessed by CT vs. TTE were 17.96 vs. 18.07 mm for right superior, 15.92 vs. 15.51 mm for right inferior, 18.54 vs. 18.42 mm for left superior, and 15.56 vs. 15.45 mm for left inferior vein. The paired differences between the assessments of CT and TTE were not significant (P ≥ 0.31) except for the right inferior vein with a CT-minus-TTE difference of 0.41 mm (P = 0.018). The follow-up PV diameters by both CT (P ≥ 0.069) and TTE (P ≥ 0.093) were not different from baseline measurements in the 17 patients who had follow-up measurements. Conclusions With a better understanding of PV anatomy in TTE imaging, assessing PV diameters by non-invasive TTE is feasible. However, the clear identification of anatomic variation might still be challenging.


2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Mandeep Singh Sondh ◽  
Rohit Tandon ◽  
Rajiv Gupta ◽  
Gurpreet Singh Wander

Abstract Background Aneurysms of the sinus of Valsalva (SOV) are thin-walled outpouchings most commonly involving the right or non-coronary sinuses. Because they are asymptomatic, they are rarely discovered before they rupture and form an aorto-cardiac fistula. We present a rare case of unruptured aneurysm of the right coronary SOV burrowing into the interventricular septum with severe aortic incompetence and left ventricular dysfunction. To our knowledge, burrowing of the SOV aneurysm (SVA) into the interventricular septum and its large sac-like appearance has never been described using three dimensional (3D) echocardiography before. Case summary A 37-year-old man presented to the cardiology outpatient department with complaints of dyspnoea and palpitations (New York Heart Association Class II–III) for the last 6 months. He was evaluated with transthoracic echocardiography which showed a large mobile sac-like structure with irregular borders bulging and prolapsing into the left ventricular cavity with each cardiac cycle along with severe aortic incompetence. On transoesophageal echocardiogram, the right coronary cusp showed malcoaptation with deformed aortic sinus causing severe aortic incompetence. Cardiac computed tomography showed sparing of right coronary artery at the origin. A diagnosis of SVA was made. The patient underwent aortic valve replacement along with partial resection of the aneurysm. The patient had an uneventful postoperative course. Follow-up echocardiography after 4 weeks showed well-seated aortic valve prosthesis with residual SVA. The ejection fraction decreased from 46–48% to 36–38%. Discussion Comprehensive multimodality imaging can be used for management strategy of SVA.


Sign in / Sign up

Export Citation Format

Share Document