Echocardiography and surgical treatment of left ventricular
pseudoaneurysm with right ventricular wall perforation after myocardial
infarction
Abstract
Rupture of left ventricular pseudoaneurysm and perforation of right
ventricular wall a are very rare.Objective: to investigate the
manifestation and contribution of ventriculography, echocardiography,
three-dimensional echocardiography, left ventricular contrast
echocardiography and right ventricular contrast echocardiography
.Methods: we analyzed 12 patients with left ventricular pseudoaneurysm
with right ventricular wall perforation, including one from our hospital
and 11 from the literature in pubmed database. Results: ①3 cases (25%)
were diagnosed by ventriculography, 9 cases (75%) were diagnosed by
echocardiography, 2 cases of pseudoaneurysm right ventricular rupture
were confirmed by Contrast Echocardiography Of Right Heart, and 1 case
was examed by left heart contrast echocardiography. due to the high
concentration of contrast agent in the right ventricle, the shunt
between the left ventricular pseudoaneurysm and the right ventricular
rupture is not obvious. One case of left ventricular aneurysm ruptured
into the right ventricle was diagnosed again by three-dimensional
ultrasound, and the complementary anatomical information of
two-dimensional ultrasound and color Doppler ultrasound could be
displayed, and the right ventricular opening could be fully evaluated.
②7 cases underwent operation, of which 1 case died of multiple organ
failure, 6 cases were good after operation, and 5 cases were not
operated. Conclusion: ①although ventriculography was previously
considered as the gold standard for the diagnosis of these rare
diseases, echocardiography is also sensitive and accurate in evaluating
left ventricular pseudoaneurysm breaking into the right ventricle. ②
timely and effective surgical treatment is the key to the prognosis of
patients