Real-time three-dimensional echocardiography in diagnosis of right ventricular pseudoaneurysm after pacemaker implantation

Echocardiography
Xuedong ShenSyed M Mohiuddin

Abstract

Right ventricular rupture is a critical cardiac complication associated with cardiac tamponade and death. Occasionally, the site of rupture may be contained by the parietal pericardium and thrombus, thus forming a pseudoaneurysm. Cases of traumatic pseudoaneurysm of the right ventricle have been reported. However, right ventricular pseudoaneurysm following pacemaker implantation has not been previously reported. This case demonstrates two right ventricular pseudoaneurysms following perforation of the right ventricular wall using real-time three-dimensional echocardiography (3DE) after pacemaker implantation although only one definite pseudoaneurysm was diagnosed by routine two-dimensional echocardiography (2DE). We also found that color Doppler 3DE enhanced visualization of the connections between the right ventricle and the pseudoaneurysm. Color Doppler 3DE allowed us to peel away the myocardial tissue and rotate the image to study the jets from different angles. In summary, real-time 3DE and color Doppler 3DE provided excellent visualization of the right ventricular pseudoaneurysm, flow between the ventricle and the pseudoaneurysm, and additional information to that obtained by 2DE.

Citations

Nov 3, 2007·The Journal of Emergency Medicine·Mikhael F El-ChamiTarek Helmy
May 9, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Stephen H LittleWilliam A Zoghbi
May 21, 2014·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Taekyung KangJae Hyung Kim
Oct 19, 2011·Circulation. Arrhythmia and Electrophysiology·Jacob S KoruthAndre d'Avila

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