Interventricular Septal Dissection in a Patient with an Old Myocardial Infarction.

Abstract

Weobserved an unusual case ofinterventricular septal wall dissection in a patient with a prior myocardial infarction. Echocardiography, magnetic resonance imaging, and left ventriculography revealed separation of the right-side and left-side walls of the interventricular septum with an accessory chamber between the two walls. Morphologic findings were consistent with interventricular septal dissection. (Internal Medicine 35: 33-35, 1996)

Chronic postinfarction pseudo‐pseudoaneurysm diagnosed by cardiac MRI

“…So far, only one case of persisting postinfarction pseudo-pseudoaneurysm was reported. In this case the dissecting hematoma resolved in the course of years, but its cavity remained chronic, while the patient was asymptomatic for many years (9).…”

“…On the other hand, in some cases a spontaneous resolution of the pseudo-pseudoaneurysm was also detected (5)(6)(7)(8). Occasionally the lesion becomes chronic (9). In our report a chronic postinfarction pseudo-pseudoaneurysm is described by cardiac MRI (CMR) in a patient who recovered from a myocardial infarction several years ago.…”

Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction

“…The large pseudoaneurysm-like structure was indeed an intramural hematoma/dissection of the interventricular septum open only on the left ventricular side. Although this mechanism was not described in the prior case reports on ventricular septal dissection [1–4], pseudoaneurysm formation and free-wall rupture in the ventricular free wall are known to occur as a result of this mechanism. In a recent case report, this was noted in a patient who underwent postmyocardial infarction VSD repair and then developed septal dissection as the necrotic tissue in the septum failed to heal [5], necessitating repeat surgical repair.…”

“…Postmyocardial infarction ventricular septal defect (VSD) is a rare complication (1/1000), and ventricular septal dissection is an even less common complication with only four case reports previously described [1–4], the first occurring in 1988. None of these cases appeared on imaging like a cross between a pseudoaneurysm and a VSD, a finding unique to our case.…”

Durchblutungsstörungen des Myokard

“…Die intramuralen Dissektionen stellen inkomplette, subakute Rupturen dar, die aus mehr oder weniger graBen, blutgefiillten, meist parallel zur OberfHiche verlaufenden Einrissen der Kammerwande oder des Septums bestehen (s. AWAN et al 1976;NAKATA et al 1996). Sie werden auch aIs intramurale Hamatome bezeichnet (Abb.…”