Spontaneous closure of a large left ventricular pseudoaneurysm after mitral valve replacement
Spontaneous closure of a large left ventricular pseudoaneurysm after mitral valve replacement
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DOI：
10.1007/s11748-014-0474-y
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发表时间：
2016-06-01
影响因子：
1.2
通讯作者：
Kinami, Hiroo
中科院分区：
文献类型：
--
作者：
Inoue, Takahiro;Hashimoto, Kazuhiro;Kinami, Hiroo
左心室假性动脉瘤是一种罕见但可能致命的疾病，通常发生在心肌梗死、感染性心内膜炎或心脏手术的并发症中。手术修补是首选的治疗方法，因为存在明显的破裂风险，但血流动力学的恶化和治疗假性动脉瘤的复杂程序可能会导致高死亡率。我们报告一位62岁女性，因风湿性二尖瓣狭窄行二尖瓣置换术后，出现较大的左室假性瘤。由于病人的拒绝，没有进行手术修复，但她的假性动脉瘤在二尖瓣置换术后2年自发消退。在接受华法林治疗的患者中，大型左心室假性动脉瘤的自发性闭塞是非常罕见的。本病例提示，颈部狭窄的左心室假性瘤在罕见的情况下可自行消退。
Left ventricular pseudoaneurysm is a rare, but potentially fatal, condition that generally occurs as a complication of myocardial infarction, infective endocarditis, or cardiac surgery. Surgical repair is the treatment of first choice because of the marked risk of rupture, but deteriorated hemodynamics and complicated procedures to treat the pseudoaneurysm may lead to a high mortality rate. We report a 62-year-old woman with a large left ventricular pseudoaneurysm after mitral valve replacement for rheumatic mitral valve stenosis. Surgical repair was not performed due to the patient's refusal, but her pseudoaneurysm resolved spontaneously by 2 years after mitral valve replacement. Spontaneous obliteration of a large left ventricular pseudoaneurysm is very rare in a patient on warfarin therapy. This case suggests that a left ventricular pseudoaneurysm with a narrow neck may resolve spontaneously in rare settings.