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Valenzuela等曾著文报道房间隔动脉瘤(ASA),并认为ASA完全是良性的不需要干预治疗。目前还不清楚对ASA有何种最好的治疗方法。本文作者有一例需要手术治疗的ASA患者,其病变位置迄今尚无人报道过。此例患者是38岁妇女,患有风湿性二尖瓣狭窄(MS)和房颤,通过经食管超声心动图(TEE)检查证实有ASA,无栓塞现象。由于左房压力高,动脉瘤凸至右侧心脏。在动脉瘤腔内有一小的凝血块。施行二尖瓣瓣膜结合切除术时取出血凝块。血凝块的形成是由于ASA血液郁滞所致。 作者强调以下几点:(1)至今不曾有人报告MS与ASA有关连。作者所报道的可能是第一例。(2)虽然有人提到ASA有血栓形成,但是在文献中未见过ASA的血栓影像,作者的报告也是唯一的一例;异常的栓塞形成可能是由房间隔分流所致,栓子直接来源于ASA。(3)由于血凝块在
Valenzuela et al. have reported atrial septal aneurysm (ASA) and believe that ASA is completely benign and does not require intervention. It is unclear what the best treatment for ASA is. The author of this article has a case of ASA patients who require surgical treatment. The location of the lesion has not been reported so far. This patient was a 38-year-old woman with rheumatic mitral stenosis (MS) and atrial fibrillation. She was confirmed by transesophageal echocardiography (TEE) to have ASA without embolism. Due to the high left atrial pressure, the aneurysm protrudes to the right heart. There is a small clot in the lumen of the aneurysm. Blood clots were removed during mitral valve resection. The formation of blood clots is due to stagnation of ASA blood. The author emphasizes the following points: (1) No one has ever reported that MS is related to ASA. The author may report the first case. (2) Although it has been mentioned that ASA has thrombosis, there is no thromboembolic image of ASA in the literature, and the author’s report is also the only one; abnormal embolization may be caused by atrial septal diversion, and emboli come directly from ASA. (3) Due to blood clots