title: A hole in the heart.
abstract: We present the case of a 91-year-old male whose percutaneous aortic valve replacement was complicated by perforation of the left ventricular (LV) apex caused by an extra-stiff guidewire. Although two-dimensional echocardiography was able to demonstrate a small hole at the LV apex and the presence of an LV pseudo-aneurysm, the exact size and shape of the hole could not be readily appreciated. Thus, three-dimensional (3D) echocardiography was performed and an oval-shaped hole of roughly 0.8 cm(2) could be clearly visualized. This case illustrates the unique value of 3D echocardiography in visualizing geometry and flow across LV rupture sites.
authors.affiliation: First Department of Medicine, University Hospital Mannheim, Mannheim, Germany.
authors.forename: Dariusch
authors.initials: D
authors.lastname: Haghi
authors.forename: Tim
authors.initials: T
authors.lastname: Suselbeck
authors.forename: Theano
authors.initials: T
authors.lastname: Papavassiliu
mesh_terms: D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000473:pathology; D015906:Angioplasty, Balloon, Coronary; D001021:Aortic Valve / Q000473:pathology*; D019560:Echocardiography, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D012421:Rupture / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy