ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
AN ANATOMOPATHOLOGIC STUDY OF MEMBRANOUS SEPTUM ANEURYSMS AND IMPORTANCE OF THEIR SURGICAL TREATMENT
Mehmet KAPLAN, Murat DEMİRTAŞ, Serdar ÇİMEN, Murat AKÇAR, Sabri DAĞSALLI, Azmi ÖZLER, *Hakan SAYRAK
Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Merkezi, İSTANBUL,
*SSK Göztepe Eğitim Hastanesi Patoloji Anabilim Dalı, İSTANBUL
We analysed 14 cases presenting with an aneurysmal formation of the membranous septum and a left-to-right communication by comparing angiographic, operative and pathological findings. We decided to apply medical treatment in 2 cases and surgical treatment in 12 cases. The mean age of the patients was 19 ± 9 years and nine of them were female, 5 were male. Cine-angiographies of all patients revealed a sac image protruding to the right ventricle at the most upper part of the inventricular septum, just below the aortic valve.

Anigographically the sac was like a glove-finger, a cauliflower, a diverticulum, or dome-shaped. Perioperative exploration of 7 cases revaled a perforated true aneurysmal sac. In three patients, perimembranous tissues were severely fibrotic, thickened or having more than one perforations. Two patients possessed a defect under the septal leaflet of the tricuspid valve at the postero-inferior part of the septum, hidden between the chordae of the valve. Defining clearly the membranous septum pathologies is not always possible, by cine-angiography. Echocardiography provides additional information for operative decision. Pathological examination of the resected specimens showed almost total loss of elastic fibers and extensive accumulation of mucopolysaccharides.

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