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首页> 外文期刊>Echo Research and Practice >Vein graft aneurysm with mural thrombus on echocardiography
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Vein graft aneurysm with mural thrombus on echocardiography

机译：超声心动图上的静脉移植物与壁膜血栓的动脉瘤

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A 78-year-old man presented with chest pain, left bundle branch block and raised troponin levels. Echocardiography demonstrated a 63?mm vein graft aneurysm with mural thrombus (Fig. 1A, B and C; Videos 1, 2, 3 and 4), and a dilated, severely dysfunctional and dyssynchronous left ventricle, with inferior akinesia. Eighteen years ago, he had undergone coronary artery bypass grafting following three myocardial infarctions. He had four grafts, including a vein graft to the left anterior descending artery (LADA). Percutaneous occlusion of this aneurysmal LADA graft had been considered when it measured 45?mm 3 years before, but on angiography, the graft contributed significantly to LADA flow and was not therefore occluded (Fig. 1D). The native LADA and two other vein grafts were occluded. Repeat computerised tomography scan revealed that the aneurysmal graft was patent, but had enlarged, compressing the pulmonary artery (Fig. 1E, F and G). The patient died from left ventricular failure. Vein graft aneurysms occur due to trauma during harvesting, weak points along the vein or atherosclerotic degeneration (1), (2). On echocardiography, it appears as a well-circumscribed, echo-lucent mass, surrounded by a crescentic, echo-dense region. Using i.v. echo-contrast agents, pulsatile diastolic flow within such aneurysms has been described before (3). Untreated aneurysms can cause myocardial infarctions, rupture and death (2).Download Figure
机译：一名78岁的男子出现胸痛，左束支传导阻滞和肌钙蛋白水平升高。超声心动图显示63毫米静脉移植物动脉瘤伴壁膜血栓（图1A，B和C;视频1、2、3和4），以及扩张，严重功能障碍和不同步的左心室，并伴有运动障碍。十八年前，他在三次心肌梗塞后接受了冠状动脉搭桥术。他有四处移植物，包括左前降支（LADA）的静脉移植物。在3年前测量该动脉瘤LADA移植物45？mm时曾考虑过经皮闭塞，但在血管造影术中，该移植物对LADA的流动有显着贡献，因此没有被闭塞（图1D）。阻塞了本地的LADA和另外两个静脉移植物。重复的计算机断层扫描显示，动脉瘤移植物已获得专利，但已扩大，压缩了肺动脉（图1E，F和G）。该患者死于左心衰竭。静脉移植物动脉瘤的发生是由于收获时的创伤，沿静脉的薄弱点或动脉粥样硬化变性（1），（2）。在超声心动图上，它表现为界限分明，回声清晰的肿块，周围环绕着月牙形，回声密集区。使用i.v.回声造影剂，这种动脉瘤内的搏动性舒张流在之前已有描述（3）。未经治疗的动脉瘤可导致心肌梗塞，破裂和死亡（2）。

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