Story of a Little Right Ventricular Pseudoaneurysm

Abstract

Cardiac trauma caused by Swann-Ganz catheter may very rarely cause cardiac perforation, tamponade and right ventricular pseudoaneurysm. In contrast to left ventricular equivalants, pseudoaneurysms of the RV have a weak tendency to rupture. Its impact on patient outcomes should be assesed very carefully depending on its size, filling rate/capacity. It is possible not to operate the patient and follow progression of RV pseudoaneurysm by clinical and echocardiographic findings. This case is a good sample for it and describes the lifespan of a small RV pseudoaneurysm. It is not only the unique right ventricle pseudoaneurysm due to cardiac trauma caused by Swann Ganz catheter, but medically treated case without surgery and recovered completely.

Right ventricular pseudoaneurysm in a young adult following right heart catheterization: a rare case report and review of the literature

“…A pseudoaneurysm results from a rupture of the ventricular wall with the containment of the resultant hematoma by pericardium or extracardiac structures [6]. It may occur after cardiac trauma, congenital heart surgery, endomyocardial biopsy, pacemaker placement, infections, post-myocardial infarction, and central venous or pulmonary artery catheterization [2]. For decades, Swan-Ganz catheter is used for measuring cardiac filling pressure and the incidence of its known complications is less than 1%, which includes the rapture of the pulmonary artery, knotting, and right ventricular free wall perforation [2,7].…”

“…It may occur after cardiac trauma, congenital heart surgery, endomyocardial biopsy, pacemaker placement, infections, post-myocardial infarction, and central venous or pulmonary artery catheterization [2]. For decades, Swan-Ganz catheter is used for measuring cardiac filling pressure and the incidence of its known complications is less than 1%, which includes the rapture of the pulmonary artery, knotting, and right ventricular free wall perforation [2,7]. Our case describes a right ventricular pseudoaneurysm after right heart catheterization in a patient with right heart failure in the setting of an atrial septal defect.…”

“…Ventricular pseudoaneurysm is a contained rupture of the ventricular wall that may occur due to cardiac trauma, congenital heart surgery, endomyocardial biopsy, pacemaker placement, central venous or pulmonary artery catheterization, infections, and postmyocardial infarction [1,2]. A cardiac pseudoaneurysm differs from a true aneurysm because its wall does not contain myocardial tissues and connects to the ventricle by a small neck.…”

“…Thus, ventricular pseudoaneurysm is prone to fatal rapture and subsequent high mortality [1,3]. Although left ventricular pseudoaneurysm is uncommon, right ventricular pseudoaneurysm is extremely rare [2,3]. Transthoracic echocardiogram, cardiac MRI, and CT angiography can help diagnosis and management [4].…”

Traumatic right ventricular rupture: Case report and brief review of the literature

“…A pseudoaneurysm of the RV myocardium is extremely rare, with very few cases reported in the literature. These reports of RV pseudoaneurysm have occurred in the setting of endomyocardial biopsy [10] , heart catheterization [11 , 12] , device-related complications [13] , blunt cardiac trauma [14 , 15] , and idiopathic [8 , 16 , 17] . Radiographically, the use of echocardiography, CTA, and cardiac MRI can be used to diagnosis, track progression, and guide management of RV pseudoaneurysms [14] .…”