Akademik Veri Yönetim Sistemi
Türk Kardiyoloji Derneği arşivi, cilt.45, sa.1, ss.104, 2017 (Diğer Kurumların Hakemli Dergileri)
Presently described is case of left ventricular (LV) posterior wall rupture contained
by posterolateral pseudoaneurysm with calcified thrombus. A 63-year-old
male was admitted to coronary intensive care unit with acute pulmonary edema
and required mechanical ventilation for 2 days. He had undergone coronary angiography
with diagnosis of unstable angina 1 year prior, and drug-eluting stent
had been implanted for 90% stenosis of proximal left anterior descending artery
(LAD). Chest radiography revealed enlarged mediastinal and cardiac silhouette.
Computed tomography scan of the chest displayed LV posterior wall rupture contained
by posterolateral pseudoaneurysm with calcified thrombus (Figure A, B,
arrows). Transthoracic echocardiogram showed dilated, hypokinetic LV with inferoposterior
hypokinesia and confirmed pseudoaneurysm 7.1x4.7 cm in size at
widest diameter and with neck length of 4 cm, extending from posterolateral to
anterolateral wall (Figure C and supplementary video 1*). Coronary angiography
revealed double vessel disease with significant stenosis diagonal LAD and total
occlusion in the proximal left circumflex artery (Supplemental video 2 and 3*).
Patient underwent open-heart surgery. Dor technique was used for endo-exclusion
of pseudoaneurysm with endopatch. Rupture was repaired with pericardial patch
and polypropylene running suture. Coronary artery bypass grafting
was performed, and procedure was completed without complications
(Figure D-G and supplementary video 4*). Unfortunately, the next
day, the patient died due to malignant arrhythmia and severe ble