RESUMEN
Objective: To evaluate the safety and efifcacy of percutaneous ventricular partitioning (PVP) in ischemic heart failure (IHF) patients with apical aneurysm. Methods: A total of 19 IHF patients with apical aneurysm at the age of (68.1 ± 8.2) years were enrolled. The patients received PVP operation with adequate clinical and medical imaging examinations; the safety of operation was evaluated and post-operative clinical events with cardiac function were followed-up. Results: There were 18/19 (95%) patients with successful PVP and 1 had to stop the operation due to unsatisfactory landing of ventricular partitioning device. 2 patients suffered from vessel access related complication and received femoral artery stent implantation. With (252 ± 170) days follow-up study, no post-operative device failure, cardiac death, thromboembolism and HF re-hospitalization occurred. At 3 months after operation, the patients had improved NYHA classiifcation (2.72 ± 0.67) vs (1.67 ± 0.59) and 6 min walk test (462 ± 96) m vs (484 ± 87) m, bothP<0.01. Echocardiography indicated that post-operative left ventricle end-diastolic volume index (LVEDVI) decreased form (137.4 ± 19.1) ml/m2 to (125.6 ± 18.5) ml/m2,P=0.0056 and LVESVI decreased from (89.7 ± 22.3) ml/m2 to (78.8 ± 20.7) ml/m2,P=0.0019; while LVEF increased from (34.8 ± 8.13) % to (41.3 ± 6.2) %, P=0.031. Conclusion: Our preliminary experience showed that with adequate evaluation, PVP was safe and effective in IHF patients with apical aneurysm; short-term follow-up study implied the improved hemodynamic and cardiac function.
RESUMEN
Atrial aneurysms involving the free wall or atrial appendage are very rare intracardiac anomalies, less than 100 case reported worldwide. It is usually detected by chance and also could be associated with atrial arrhythmias or systemic embolism. Transthoracic echocardiography and cardiac MRI is the standard diagnostic modality. Aneurysmectomy is usually recommended especially in symptomatic cases. We review the literature and report a case of atrial appendiceal aneurysm, a 23 year-old young man whose diagnosis was established with transthoracic echocardiography and cardiac CT angiography.