Incidental discovery of a membranous ventricular septal aneurysm in two dissimilar patients. Case Rep Cardiol. 2012;2012:324326. [PMID: 24826245 PMCID: PMC4008397 DOI: 10.1155/2012/324326]

Multimodal Imaging Characterization of a Congenital Multilobular Interventricular Membranous Septal Aneurysm in a Patient Presenting with Embolic Stroke

• TTE is often performed to search for cardiac sources of emboli. • TTE must be comprehensive and assess the atria, valves, and ventricles. • TTE can be utilized to identify IVMSA as a rare cause of recurrent strokes. • Comprehensive imaging studies should be utilized to confirm the diagnosis of IVMSA. • Multidisciplinary care is necessary in the management of these patients.

A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm

BACKGROUND

Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience.

METHODS

This was a retrospective study for consecutive 12 pregnancies in women with MVSA, who delivered at a tertiary care center in west China between May 2008 and March 2015.

RESULTS

All patients with MVSA delivered via caesarian section. One patient with severe pulmonary arterial hypertension expired from pulmonary infection and heart failure after delivery. One patient terminated pregnancy in the second trimester- necessitated by cardiogenic shock. The other mothers had varying degrees of cardiac morbidity, but survived. Ten of thirteen newborns survived. Congenital heart disease and small-for-gestational-age (SGA) of newborn occurred in two cases (one twin and one single gestation). Two of these babies expired.

CONCLUSIONS

Maternal and neonatal risk appeared associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmia. Accurate diagnosis and care by a multidisciplinary team is recommended for pregnant woman with MVSA.

Interventricular Membranous Septal Aneurysm Incidentally Diagnosed During Computed Tomographic Angiography in a Patient with Infrequent Supraventricular Tachycardia

Interventricular membranous septal (IVMS) aneurysm is a rare condition with no accurate incidence. It is known to be associated with 0.3 % of congenital heart disease and 19 % of ventricular septal defects. IVMS aneurysm is often asymptomatic but can be complicated with right ventricular obstruction, rupture, thromboembolism, and conduction defects. Clinicians and radiologist should be aware about this rare clinical entity and evaluation of any possible underlying cardiac abnormalities should be performed. Conservative management with close follow up is the mainstay of management in the absence of complication.

Multimodal imaging of the tricuspid valve: normal appearance and pathological entities

The tricuspid valve, which is the atrioventricular valve attached to the morphological right ventricle, is affected by a wide range of pathological processes. Tricuspid valve diseases are now increasingly recognized as a significant cause of morbidity and mortality. Echocardiography is the most widely available and, hence, the first-line imaging modality used in the evaluation of tricuspid valve disorders; however, CT and MRI are also increasingly used for further evaluation and characterization of these entities. In this article, we first review the normal anatomy and embryology of the tricuspid valve, followed by a discussion of the role of multiple imaging modalities in the evaluation of tricuspid valve abnormalities. We then review and illustrate the imaging appearance of several congenital and acquired tricuspid valve abnormalities.

Main Messages

• Tricuspid valve diseases have a significant impact on morbidity and mortality.

• CT and MRI are increasingly used in the evaluation of tricuspid disorders.

• CT and MRI help in diagnosis, functional evaluation, pre-surgical planning and post-surgical follow-up.

• The most common cause of tricuspid regurgitation is functional.

Radiological features of uncommon aneurysms of the cardiovascular system

Although aortic aneurysms are the most common type encountered clinically, they do not span the entire spectrum of possible aneurysms of the cardiovascular system. As cross sectional imaging techniques with cardiac computed tomography and cardiac magnetic resonance imaging continue to improve and becomes more commonplace, once rare cardiovascular aneurysms are being encountered at higher rates. In this review, a series of uncommon, yet clinically important, cardiovascular aneurysms will be presented with review of epidemiology, clinical presentation and complications, imaging features and relevant differential diagnoses, and aneurysm management.