Pulsatil torakal kitle:  Nadir g�r�len bir sol ventrik�l ps�doanevrizmas�

G�LER, Adem; U�AK, Alper; BA�ARAN, Murat; �ZEN, Y�cel; Us, Melih Hulusi; Y�lmaz, Ahmet Turan

Cilt : 30 Say� : 12 Y�l : 2024

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Pulsatil torakal kitle: Nadir g�r�len bir sol ventrik�l ps�doanevrizmas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2009; 15(2): 198-200

Pulsatil torakal kitle: Nadir g�r�len bir sol ventrik�l ps�doanevrizmas�

Adem G�LER, Alper U�AK, Murat BA�ARAN, Y�cel �ZEN, Melih Hulusi Us, Ahmet Turan Y�lmaz
Gata Haydarpa�a E�itim Hastanesi Kalp Damar Cerrahi Servisi, �stanbul

ve ventrik�ler cerrahi sonras� geli�irler. Bu yaz�da, toraks �n duvar�nda pulsasyonu kolayca g�r�lebilen bir sol ventrik�l ps�doanevrizmas� sunuldu. Elli be� ya��ndaki kad�n hasta, koroner arter baypas (CABG) ve sol ventrik�l ger�ek anevrizma onar�m ameliyat� sonras� alt�nc� haftada klini�e sol toraks �n duvar�nda kolayl�kla g�r�len ve trill al�nan pulsatil kitle ile ba�vurdu. Kontrastl� toraks tomografisinde, sol toraks �n duvar�nda interkostal mesafeyi a��p cilt alt� ya� dokusuna yak�nl�k g�steren yumu�ak doku kitlesi g�r�ld�. Sol ventrik�lografide geni� bir sol venrik�l apikal ps�doanevrizmas� saptand�. Femoral kan�lasyon ile kardiyopulmoner baypasa girilen hastada, endo-anevrizmorafi ve CABG x 1 ameliyat� ger�ekle�tirildi. Hasta 15. g�n �ifa ile taburcu edildi. Kontrol ekokardiyografisinde ba�ar�l� anevrizma tamiri rapor edilen hasta, ameliyat sonras� be�inci ayda olup takibi devam etmektedir. Sol ventrik�l ps�doanevrizmas� s�kl�kla kalp yetersizli�i ile kendini g�sterir, ancak baz� hastalar n�kseden ta�iaritmi, tromboembolizm, progresiv dispne, non-spesifik g��s a�r�s� ya da hafif �ikayetlerle ba�vurabilirler. Kalp cerrahisi ge�irmi� ve g��s �n duvar�nda pulsatil kitle �ikayetiyle ba�vuran bir hastada mutlaka sol ventrik�l ps�doanevrizmas� ay�r�c� tan�da d��n�lmelidir.

Anahtar Kelimeler: G��s pulsatil kitle, sol ventrik�l ps�doanevrizma.

Pulsatile thoracal mass: a rare case of large left ventricular pseudoaneurysm

Adem G�LER, Alper U�AK, Murat BA�ARAN, Y�cel �ZEN, Melih Hulusi Us, Ahmet Turan Y�lmaz
Department Of Cardiovascular Surgery, Gata Haydarpafla Training Hospital, Istanbul, Turkey

Left ventricular pseudoaneurysms (LVPA) develop after myocardial infarction, trauma, infection and either valvular or ventricular surgery. We present here an unusual case of LVPA appearing like a pulsatile mass, which was easily seen from the chest wall. A 55-year-old woman was admitted to our clinic with a pulsatile mass and trill, easily seen on the anterior chest wall 6 weeks after coronary artery bypass graft (CABG) surgery and endoaneurysmorrhaphy operation. Contrast-enhanced tomography showed a soft tissue mass detected close to the subcutaneous fat tissue of the anterior chest wall located in the left hemithorax. Left ventriculography was consistent with a large pseudoaneurysm in the apical wall of the left ventricle. Cardiopulmonary bypass was established with femoral cannulation, and endoaneurysmorrhaphy and CABG x 1 operations were carried out. The patient was discharged home on postoperative day 15. Follow-up echocardiography showed successful repair and shrinkage of the aneurysm, and the patient remained asymptomatic without any clinical event during our follow-up. LVPA usually present with heart failure. However, some patients may have recurrent tachyarrhythmia, progressive dyspnea, nonspecific chest pain, or thromboembolism, or remain clinically silent. When a patient is seen after cardiac surgery with a pulsatile mass detected on the chest wall, LVPA should be considered in the differential diagnosis.

Keywords: Thoracal pulsatile mass, left ventricular pseudo-aneurysm.

Sorumlu Yazar: Adem G�LER, T�rkiye
Makale Dili: T�rk�e

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