Dissecting Aneurysm of the Interatrial and Interventricular Septum with Concomitant Ventricular Septal Defect—Multimodality Cardiac Imaging and Surgical Repair

We report an exceedingly rare case of spontaneous dissecting aneurysm involving the interatrial and interventricular septum, concomitant ventricular septal defect in an 8‐year‐old girl, echocardiographic and multislice computed tomographic imaging, and successful surgical repair.     

Lipomatous hypertrophy of the interatrial septum

Lipomatous hypertrophy of the interatrial septum is a rare conditionand it does not require any specific treatment. We present thetransoesophageal echocardiogram findings of a 70-year-old ladydemonstrating the appearances that were typical of lipomatoushypertrophy of the interatrial septum.     

扩张性透明隔囊肿71例临床分析

目的探讨透明隔囊肿的临床特点及其引起临床症状和体征的可能机制.方法回顾性分析了自1991年1月-2004年12月诊治的71例扩张性透明隔囊肿的临床资料.结果发现扩张性透明隔囊肿最常见的临床表现是头痛、癫痫、昏厥、精神障碍和神经症.出现症状至就诊的时间为4.77年±2.86年.药物治疗有效率为66.13%,手术治疗有效率为100.00%.结论扩张性透明隔囊肿临床表现缺乏特异性,药物治疗部分有效,手术治疗效果佳.     

Cardiac Gunshot Injury: Child with Stable Presentation and Asymptomatic Short‐Term Follow‐up

A 2‐year‐old female child was brought to the emergency department after she was accidentally shot by her father, while cleaning his air rifle loaded with the pointed type 0.22 (5.5 mm) caliber pellet. The pellet hit the front of chest from a distance of about 10–15 m. On physical examination, it was found that there was entrance wound in right lower parasternal area but no exit wound. She was hemodynamically stable with normal auscultatory findings. Chest roentgenogram ( Fig. 1 ) demonstrated a bullet overlying cardiac silhouette with no other findings. Two‐dimensional transthoracic echocardiography ( Figs, 2, 3 , and movie clip 1) showed an echogenic density in the interventricular septum just beneath the insertion of tricuspid and mitral leaflets. The atrioventricular valves appear normal with no regurgitation. The biventricular function also appeared normal with no regional wall motion abnormalities. There was no pericardial effusion present. The echogenicity is most likely the pellet that punctured the chest wall and continued inward to lodge in the interventricular septum. Computed tomographic scan of the chest showed an intracardiac foreign body without other abnormalities. Up to 11 months, repeated scans have shown no changes. She will continue to receive ongoing follow‐up to assess for late complications (migration, erosion, conduction, disturbance, etc.) To the best of our knowledge, she may be the youngest living patient having cardiac trauma with clinically stable presentation and asymptomatic short‐term follow‐up. (Echocardiography 2010;27:208‐209)

Figure 1 Open in figure viewer PowerPoint Chest x‐ray. Anteroposterior and lateral view. Arrow demonstrating pointed pellet overlying cardiac silhouette.     

A Ventricular Septum Filleted Down the Middle

Trauma inflicted by sharp penetrating objects can cause unusual and complex injuries to the heart. We present a case where penetrating trauma caused an unusual ventricular laceration that filleted the ventricular septum into two separate sections creating an artificial chamber in between. The ventricular septal defect was clearly displayed with echocardiography and required special cardiac surgical intervention .     

老年人顽固性鼻出血的处理

目的：探讨老年人顽固性鼻出血的治疗方法及疗效。方法：回顾性分析72例老年人顽固性鼻出血的治疗经过及资料。结果：72例中,50例与鼻中隔偏曲有关的患者施行了鼻中隔矫正术并取得良好上血效果,其中只有2例因再次鼻出血复行血复行血管栓塞术止血;有10例无严重心血管疾病患者行数字减影造影及血管栓塞术成功止血;另有12例在鼻内窥镜下检查及止血且效果良好。结论：与鼻另隔偏曲有关的老年人顽固性鼻出血患者应考虑施行鼻中隔粘骨膜下矫正术;数字减影造影及血管栓塞术是一种有效的治疗顽固性鼻出血的方法,但要严格掌握适应证。在鼻内窥镜下检查及止血,效果好且痛苦小,尤其适用于老年患者,值得推广应用。     

Membranous remnant of left venous valve of inferior vena cava: implications for device closure of atrial septal defects.

We described three pediatric cases during which we encountered a rarely described component of the atrial septum, a membranous remnant of the left venous valve of the IVC, in patients who were brought to the catheterization lab for device closure of an atrial septal defect. In all cases, this remnant was not noted by previous transthoracic imaging. Awareness of this potential anatomic variation is important to successful device closure of atrial septal defects.     

Atrial septal motion in obligatory right to left shunt

An adult patient with a hypoplastic right heart with intact ventricular septum, pulmonary atresia, secundum ASD and a PDA was studied by 2-D echocardiography. A striking flap valve motion of the primum portion of the interatrial septum was observed. This is perhaps the first report of its kind in an adult.     

选择性右下肺动脉造影房间隔穿刺定位法

本文就经皮穿刺球囊二尖瓣成形术X光透视下对心房双重影欠佳时，采用手推5～10ml造影剂经右下肺动脉造影法，当造影剂经右下肺静脉流入左心房时，左心房下缘影即可清晰显露，从而方便进行房间隔穿刺定位。临床应用26例，全部成功，无任何并发症。此法简单、安全、易掌握，值得临床推广应用。     

The Effect of Snoring on Atrial Septum

While performing transesophageal echocardiograms, on two occasions we observed extreme atrial septal bulging into the lefi atrium during stertor. (ECHOCARDIOGRAPm, Volume 15, October 1998)     

Interventricular septal hydatid cyst

In this report we describe an unusual case of cardiac echinococcus located in the interventricular septum invaded by a cystic mass. It was demonstrated by using transthoracic echocardiography (TTE) and confirmed with magnetic resonance imaging (MRI). Surgical excision (cystopericystectomy) was performed on the patient as a curative therapy. Early recurrence was observed despite additional medical therapy with albendazole.     

Multiplane Transesophageal Echocardiographic Evaluation of Defects of the Atrioventricular Septum: The Crux of the Matter

The availability of multiplane transesophageal probes has dramatically facilitated visualization of complex cardiac anatomy, with full dynamic tracking of anatomic contiguity. This report describes the unique applicability of multiplane transesophageal echocardiography (TEE) for visualization and assessment of a spectrum of congenital cardiac defects involving the cardiac crux, including the atrioventricular septum, inlet muscular septum, and the atrioventricular valves. With further evolution and progressive miniaturization of these probes, the use of this echocardiographic modality will hopefully encroach into the young infant age range, permitting enhanced preoperative and perioperative depiction of complex congenital cardiac anatomy.     

Rhabdomyoma of the interventricular septum in a neonate--two-dimensional echocardiographic features

A case of rhabdomyoma of the interventricular septum in a neonateis presented. The clinical, echocardiographic and angiographicfeatures are described. Real-time two-dimensional echocardiographydiagnosed the tumour prior to cardiac catheterization, and hassubsequently been used in serial assessment of the tumour size.     

室间隔对心功能作用的实验研究

目的评价室间隔在维持心功能中的作用,特别是对右心功能的作用。方法选择健康杂种犬７只,形成室间隔心肌梗塞动物模型,梗塞前后施加压力负荷即环缩肺动脉和环缩主动脉,应用超声心动图观察心功能的改变。结果室间隔梗塞后左室收缩压及右室收缩功能明显降低。动脉携氧量及氧运输量减少。二尖瓣Ｅ／Ａ减小,左室等容舒张时间间期延长;三尖瓣Ｅ／Ａ＜１。收缩期室间隔厚度及收缩期增厚率降低,左室游离壁收缩期增厚率增加,而右室游离壁变化不明显。同样程度的右室压力负荷、右室收缩压升高幅度明显低于梗塞前（Ｐ＜０．０１）,且舒张压较前升高;同样程度的左室压力负荷,左室收缩压升高幅度较前降低（Ｐ＜０．０１）,右室收缩压随之升高的幅度也降低（Ｐ＜０．０１）。结论室间隔不仅参与了左心功能的维持,对右心功能的维持更重要。     

Endocardial Blood Cyst: A Rare Site and Age of Presentation

Cardiac blood cysts are rare findings in clinical practice. They usually involve the valves and are very uncommon in adult age. Their clinical manifestation varies broadly, as they can interfere with intracardiac flow, or even be completely silent. We report a case of a newly developed cyst of the atrial septum, incidentally detected by transthoracic echocardiography in a 69‐year‐old asymptomatic patient. The diagnosis was confirmed by postsurgery histopathological examination. (Echocardiography 2011;28:E50‐E52)     

Morphology of perforated atrial septal aneurysm suitable for closure by transcatheter device placement

OBJECTIVE—To define the morphological criteria of perforated atrial septal aneurysms suitable for closure by a transcatheter device.
METHODS—A retrospective analysis of all consecutive patients with atrial septal aneurysm and one or more perforations presenting between May 1997 and June 1999. The aneurysms were classified as: aneurysm with persistent foramen ovale (type A); aneurysm with single atrial septal defect (type B); aneurysm with two perforations requiring more than one device for closure (type C); and aneurysm with multiple perforations (type D).
PATIENTS—Data from 50 patients aged 5-78 years (mean 43 years) were analysed; 32 had systemic thromboembolism or transient ischaemic attacks, eight presented with dyspnoea on exercise, and 10 were discovered incidentally but had significant left to right shunt and right ventricular volume overload.
RESULTS—In all 18 patients with aneurysm and persistent foramen ovale (type A), transcatheter closure was possible. In nine with aneurysm and atrial septal defect (type B), five defects were closed and four required surgery. Device closure was achieved in all 10 patients with aneurysms and two perforations (type C), but four had a residual shunt. Thirteen patients with multiple perforated aneurysms (type D) underwent surgery.
CONCLUSIONS—This classification of morphology of perforations of aneurysm is clinically useful for selecting patients for treatment by transcatheter devices.