<症例>右室左室両方に交通孔をもつ心筋梗塞による仮性心室瘤の1例

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We report a case with pseudoaneurysm which has a separate communication of the right and left ventricles. This was a 59 years old Japanese male, who was admitted to our Hospital in June, 1980 for complete check-up of cardiac murmur. Three months before admission, he had a visual disturbance and was hospitalized, when he was told that he had a cardiac murmur. He was diabetic and had a history of cerebrovascular accident. Physical examination revealed pansystolic murmur of Levine IV grade at Erb area. Electrocardiogram showed an old inferior myocardial infarction. Echocardiograms revealed an abrupt discontinuity of the left ventricular posterior wall at the base and a large echo-free space posteriorly. Cardiac catheterization showed an oxygen step-up at the right ventricle and the left-to-right shunt was calculated as 69%. Mean pulmonary artery pressure was 2OmmHg. Left ventriculograms demonstrated a pseudoaneurysm at the posterobasal portion of the left ventricle with a narrow orifice. The contrast material injected in the left ventricle opacified the right ventricle as well as the pseudoaneurysm. Coronary angiograms showed 99% occlusion of the right coronary artery. Two months after admission, pseudoaneurysmectomy was performed. On operation, we confirmed the pseudoaneurysm with separate communication to the right and left ventricles. The patient died of multiple organ failure on the 7th postoperative day. Pseudoaneurysm of the left ventricle is a relatively uncommon complication of myocardial infarction. Most cases have a single opening to the left ventricle. Several cases who were complicated by ventricular septal perforation had been reported. The present report is the first case to our knowledge of pseudoaneurysm which has each separate communication to the right and left ventricles.
近畿大学の論文
1985-09-25

<症例>右室左室両方に交通孔をもつ心筋梗塞による仮性心室瘤の1例

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