Precision Diagnosis and Treatment of a Giant Pseudoaneurysm of the Right Ventricular Outflow Tract
Keywords:Pseudoaneurysm, right ventricular outflow tract, tetralogy of Fallot, echocardiography, computer tomography
Pseudoaneurysm (PSA) of the right ventricular outflow tract (RVOT) is an exceedingly rare adverse event after the surgical reconstruction of the RVOT for the treatment of congenital heart disease. We report an unusual giant PSA of RVOT in a 20-month-old child, who underwent correction of the tetralogy of Fallot. Her main symptoms were in the respiratory system, and chest X-ray also revealed the giant space-occupying lesion in the chest, which could’ve been misdiagnosed as a respiratory disease. After evaluation by the combination of echocardiography and cardiac computer tomography angiogram, the details of PSA were diagnosed, and surgical but not percutaneous intervention was selected. The exclusion of PSA successfully was performed by the femoral cannulation, exploratory through right ventriculotomy, closure of the defect using the Gore-Tex patch, and application of a retained drainage-tube inside the PSA.
Herbert C, Ikemba C, Nugent A. 2014. Device closure of a pseudoaneurysm of the right ventricular outflow tract in an infant with right ventricle-to-pulmonary artery homograft. Catheter Cardiovasc Interv 83(4): 587-90.
Kaza AK, Lim HG, Dibardino DJ, et al. 2009. Long-term results of right ventricular outflow tract reconstruction in neonatal cardiac surgery: options and outcomes. J Thorac Cardiovasc Surg 38(4): 911-6.
Lupattelli T. 2006. The yin-yang sign. Radiology 238(3): 1070-1.
Lurz P, Taylor A, Bonhoeffer P. 2007. Percutaneous treatment of a giant right ventricular outflow tract pseudo-aneurysm and severe pulmonary regurgitation. Eur Heart J 28(17): 2086.
Sykes MC, Nathan M, Sanders SP, et al. 2017. Pseudoaneurysm complicating right ventricle-to-pulmonary artery conduit surgery: Incidence and risk factors. J Thorac Cardiovasc Surg 154(6): 2046-2049.