title: Traumatic free wall and ventricular septal rupture - 'hybrid' management in a child.
abstract: A 8-year-old boy showed a traumatic ventricular septal rupture following a blunt chest trauma, and was scheduled for elective catheter closure. Two weeks later, a follow-up echocardiogram revealed a pseudoaneurysm of the anterior wall of the left ventricle. Because of the apical location of the VSD, it was decided to proceed with transcatheter occlusion. After successful VSD closure, the patient was taken to the operation room for surgical repair of the left ventricular pseudoaneurysm. Symptoms and signs seen in patients with ventricular pseudoaneurysms appear to be discrete and variable, and a high clinical index of suspicion with a very close echocardiographic follow-up is strongly recommended after occurrence of a blunt cardiac trauma. The combined 'hybrid' approach of transcatheter closure of the intraventricular rupture followed by surgical closure of the pseudoaneurysm allows for a less invasive and efficient management of this rare combination of post-traumatic ventricular free wall and septal rupture in a child.
authors.affiliation: Division of Congenital Cardiac Surgery, Children's Hospital, University Zurich, Switzerland. a.kadner@web.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Kadner
authors.forename: Margrit
authors.initials: M
authors.lastname: Fasnacht
authors.forename: Oliver
authors.initials: O
authors.lastname: Kretschmar
authors.forename: René
authors.initials: R
authors.lastname: Prêtre
mesh_terms: D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery; D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D004452:Echocardiography / Q000379:methods; D006322:Heart Aneurysm / Q000209:etiology / Q000601:surgery; D006346:Heart Septum / Q000601:surgery; D006736:Horses; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000209:etiology / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000628:therapy