Document Detail

Respiratory distress after surgery of RVOT pathologies: a word of caution on pseudoaneurysm development.
MedLine Citation:
PMID:  20824590     Owner:  NLM     Status:  MEDLINE    
Pseudoaneurysm of the right ventricle outflow tract (RVOT) is a rare complication in pediatric cardiac surgery. We report a patient who developed a right ventricular pseudoaneurysm 8 months after RVOT enlargement using a pericardial patch for infundibular pulmonary stenosis. Our patient was born with severe pulmonary valvular stenosis and treated with percutaneous balloon valvotomy in the neonatal period. Six months later, she developed infundibular pulmonary stenosis, which required surgical resection of right ventricle infundibular trabeculations and bovine pericardial patch enlargement. The postoperative period was normal. She was readmitted to hospital 5 months later complaining of wheezing, coughing and shortness of breath. Echocardiography showed a huge aneurysmal dilatation of the outflow patch in connection with the right ventricular cavity. The patient underwent resection of the pseudoaneurysm and former patch, followed by interposition of a bovine jugular vein conduit between the RVOT and pulmonary bifurcation. The early postoperative period was uncomplicated. On echocardiography, no significant residual gradient was measured through the conduit and there was no insufficiency of the valve. RVOT reconstruction with patch enlargement, homograft or conduit implantation can be the origin of pseudoaneurysms. Although their incidence is rare, they are often asymptomatic before becoming quite large and causing compression symptoms as in our patient with respiratory complaints due to airway compression. It is important to follow up these patients closely, especially in the first year after surgery since most aneurysms develop within 6 months of surgery.
A Donmez Antal; M Cikirikcioglu; P O Myers; D Didier; A Kalangos
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-09-07
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  58     ISSN:  1439-1902     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-08     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  356-8     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart, New York.
Department of Cardiovascular Surgery, University Hospital and Medical Faculty of Geneva, Geneva, Switzerland.
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MeSH Terms
Aneurysm, False / diagnosis,  etiology*,  surgery
Balloon Dilation
Cardiac Surgical Procedures / adverse effects*
Heart Aneurysm / diagnosis,  etiology*,  surgery
Infant, Newborn
Magnetic Resonance Imaging
Pericardium / transplantation*
Pulmonary Subvalvular Stenosis / diagnosis,  surgery*
Respiratory Insufficiency / etiology*
Treatment Outcome

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