title: Surgical repair of true left ventricular aneurysm in an infant: a rare complication after unsuccessful perventricular VSD closure.
abstract: A 2.5-month-old female patient presented for closure of a ventricular septal defect (VSD). Transthoracic echocardiography showed a large muscular ventricular septal defect. After perventricular closure of the defect was performed with an Amplatzer muscular VSD occluder, peroperative transesophageal echocardiography revealed that the device had been implanted in the wrong area of the ventricular septum. The device was retrieved and a large mid-muscular defect with extension to the outlet septum was closed with a patch of Dacron which was secured with 5-0 sutures. A perforation in the ventricular septum due to attempted perventricular device delivery was seen, and it was repaired primarily. In the eighth month of follow-up, transthoracic echocardiography revealed an aneurysm in the posterior wall of the left ventricle. The patient's electrocardiogram showed pathological Q waves and ST-segment elevation in leads DII, DIII, and aVF consistent with subacute inferior myocardial infarction. At subsequent surgery, this was found to be a true aneurysm, located in area of distribution of the obtuse marginal branch of the left circumflex coronary artery in the posterior wall of the left ventricle. The aneurysm was closed off using a Dacron patch, and the sac was resected. Development of a true aneurysm is a rare but important complication of attempted perventricular VSD closure.
authors.affiliation: Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
authors.forename: Isa
authors.initials: I
authors.lastname: Ozyilmaz
authors.affiliation: Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey saygimrt@gmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Saygi
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Yildiz
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Erek
authors.affiliation: Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Guzeltas
mesh_terms: D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D007223:Infant; D019919:Prosthesis Implantation / Q000009:adverse effects*; D011859:Radiography; D012086:Reoperation; D055989:Septal Occluder Device / Q000009:adverse effects*; D014463:Ultrasonography
keywords: child; complication; left ventricular aneurysm; perventricular vsd closure