Clinical Significance of Incidentally Detected Aneurysms of the Membranous Ventricular Septum in Adults by Multidetector Computed Tomography

You, Ja Yeon; Chun, Eun Ju; Choi, Seo-Young; Joe, Eugene; Lee, Whal; Kang, Joon Won; Seo, Moo Lyong; Yoon, Yeon Yee; Oh, Il-Young; Kim, Eun‐Hee; Lim, Tae Hwan

doi:10.1016/j.amjcard.2014.11.010

Cited by 2 publications

(5 citation statements)

References 28 publications

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“…40 In 55 (0.17%) of the 30,120 adults with suspected coronary artery disease, an aneurysm of the ventricular membranous septum was incidentally detected during cardiac multidetector computed tomography. 45 In only 1 of 48 patients operated on for a VSD with a tricuspid pouch, the pouch produced a 40 mm Hg pressure gradient in the right ventricular outflow tract. 46 Yilmaz et al 47 reported an aneurysm of the ventricular membranous septum in 51 (20%) of 254 adult patients with a perimembranous VSD diagnosed by angiography.…”

Section: Discussionmentioning

confidence: 99%

“…Seven (17%) patients had a history of bacterial endocarditis. You et al 45 reported that conduction abnormalities were noted in 25% and embolic stroke occurred in 14% and that aneurysm of the membranous ventricular septum in adults should not be ignored. Furthermore, Fabijanic et al 52 suggested that aneurysm of the membranous interventricular septum is the most likely source of recurrent transient ischemic attack.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] However, the follow-up period for every report is brief. You et al 45 reported no change in the size or the morphology during a maximum follow-up period of 61 months in adults. So far, to the best of our knowledge, no report describes the long-term follow-up of an aneurysm of the ventricular membranous septum of this size.…”

Section: Differentiation Between a Tricuspid Pouch And A True Aneurys...mentioning

confidence: 96%

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Right Ventricular Outflow Tract Obstruction by an Aneurysm of the Ventricular Membranous Septum: A Systematic Review of Case Reports

Miyake,

Inoue,

Mushiake

2024

World J Pediatr Congenit Heart Surg

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We performed a literature search to identify the details of patients with right ventricular outflow tract obstruction caused by an aneurysm of the ventricular membranous septum in a perimembranous ventricular septal defect. Thirty-one cases with a median age of 29 years (range, 1-69 years) were studied. A right ventricle-pulmonary artery systolic pressure gradient ranged from 35 to 107 mm Hg (mean 69 mm Hg). An interventricular shunt was absent in eight patients: two children and six adults. It is necessary to monitor the size of an aneurysm of the ventricular membranous septum, whether or not an interventricular shunt is present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Differentiation Between a Tricuspid Pouch And A True Aneurys...mentioning

confidence: 96%

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Right Ventricular Outflow Tract Obstruction by an Aneurysm of the Ventricular Membranous Septum: A Systematic Review of Case Reports

Miyake,

Inoue,

Mushiake

2024

World J Pediatr Congenit Heart Surg

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“…[ 19 , 20 ] The presence of turbulent flow within the AVMS, which is prone to thrombus formation, promotes the development of embolic events. Some reports suggest that intra-aneurysmal thrombosis is present in 11.6% of adult patients with AVMS, [ 4 ] which is a clear independent predictor of embolic stroke. CE events due to an AVMS are rarely reported because the coronary arteries do not follow a relatively linear trajectory of the left ventricular outflow tract.…”

Section: Discussionmentioning

confidence: 99%

“…An aneurysm of the ventricular membranous septum (AVMS) is a rare congenital malformation of the heart originating from the membranous ventricular septum. Embolic stroke has been reported to occur in 14% of patients with an AVMS, [ 4 ] but no cases of an AVMS leading to CE have been reported. We report the first case of a patient with multiple CEs with acute inferior wall infarction as the first presentation.…”

Section: Introductionmentioning

confidence: 99%

Typical clinical presentation of acute myocardial infarction and confusing coronary angiography: A case report and literature review of coronary embolism

2023

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Rationale: The purpose of this article is to discuss the characteristics, diagnosis, treatment, and outcomes of cases of multiple coronary embolism (CE) highly suspected to be caused by a dislodged aneurysm of the ventricular membranous septum (AVMS) thrombus. Patient concerns: A 35-year-old man was rushed to the Chest Pain Center of Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine for sudden onset of chest pain. The patient had severe and persistent chest pain without relief, accompanied by sweating throughout the body. Diagnosis: An electrocardiogram showed ST-segment elevation in the inferior wall leads, and blood tests suggested elevated troponin I levels. The initial diagnosis was acute ST-segment elevation myocardial infarction. Emergency coronary angiography revealed complete occlusion of the first diagonal branch, thrombolysis in myocardial infarction grade 0 flow, and smooth remaining vessels. Complete occlusion of the left anterior descending artery unexpectedly occurred during interventional treatment. Postoperative cardiac ultrasonography revealed the presence of a thrombus within the AVMS and in the apical portion of the heart. The final diagnosis was a CE. Interventions: Intraoperatively, the diagonal branch occluded segment was dilated with a balloon and intracoronary administration of tirofiban and nitroglycerin. Postoperatively, antithrombotic therapy (aspirin, clopidogrel, and rivaroxaban) was administered. Outcomes: Ten days after admission, a repeat coronary angiography showed complete restoration of left anterior descending artery flow on its own, balloon dilation was again performed on the diagonal branch, and flow was restored to thrombolysis in myocardial infarction grade 1. Six months later, the intracardiac thrombus disappeared on repeat cardiac ultrasound. Lessons: AVMS is a potential source of embolism in patients with CE. CE has features that distinguish it from atherosclerosis, and a timely and correct diagnosis can help improve patient clinical outcomes.

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Clinical Significance of Incidentally Detected Aneurysms of the Membranous Ventricular Septum in Adults by Multidetector Computed Tomography

Cited by 2 publications

References 28 publications

Right Ventricular Outflow Tract Obstruction by an Aneurysm of the Ventricular Membranous Septum: A Systematic Review of Case Reports

Right Ventricular Outflow Tract Obstruction by an Aneurysm of the Ventricular Membranous Septum: A Systematic Review of Case Reports

Typical clinical presentation of acute myocardial infarction and confusing coronary angiography: A case report and literature review of coronary embolism

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