Septal aneurysm and right ventricular obstruction: a case report

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Ventricular septal defects (VSDs) can present with complex hemodynamics.
• Right ventricular hypertrophy is a potential complication of certain VSDs.
• Membranous septal aneurysms are rare but significant cardiac abnormalities.

Observation:

• A 32-year-old male with a history of VSD presented with murmurs and right ventricular hypertrophy.
• Echocardiography revealed systolic bulging of the interventricular septum.
• Left ventricular angiography identified a membranous septal aneurysm causing a 35 mm Hg right ventricular gradient.

Findings:

• The interventricular septal aneurysm was the cause of the observed hemodynamic abnormality.
• Surgical plication of the aneurysm successfully eliminated the abnormal septal protrusion.
• Post-plication, the patient's murmurs resolved, indicating successful treatment.

Implications:

• Surgical plication is an effective treatment for membranous septal aneurysms causing significant gradients.
• Accurate diagnosis via echocardiography and angiography is crucial for appropriate management.
• This case highlights the importance of recognizing and treating rare VSD complications.