Echocardiography and surgical treatment of left ventricular pseudoaneurysm with right ventricular wall perforation after myocardial infarction

Rupture of left ventricular pseudoaneurysm and perforation of right ventricular wall a are very rare. Objective: to investigate the manifestation and contribution of ventriculography, echocardiography, three-dimensional echocardiography, left ventricular contrast echocardiography and right ventricular contrast echocardiography . Methods: we analyzed 12 patients with left ventricular pseudoaneurysm with right ventricular wall perforation, including one from our hospital and 11 from the literature in pubmed database. Results: ①3 cases (25%) were diagnosed by ventriculography, 9 cases (75%) were diagnosed by echocardiography, 2 cases of pseudoaneurysm right ventricular rupture were confirmed by Contrast Echocardiography Of Right Heart, and 1 case was examed by left heart contrast echocardiography. due to the high concentration of contrast agent in the right ventricle, the shunt between the left ventricular pseudoaneurysm and the right ventricular rupture is not obvious. One case of left ventricular aneurysm ruptured into the right ventricle was diagnosed again by three-dimensional ultrasound, and the complementary anatomical information of two-dimensional ultrasound and color Doppler ultrasound could be displayed, and the right ventricular opening could be fully evaluated. ②7 cases underwent operation, of which 1 case died of multiple organ failure, 6 cases were good after operation, and 5 cases were not operated. Conclusion: ①although ventriculography was previously considered as the gold standard for the diagnosis of these rare diseases, echocardiography is also sensitive and accurate in evaluating left ventricular pseudoaneurysm breaking into the right ventricle. ② timely and effective surgical treatment is the key to the prognosis of patients