Objective
Ventricular septal aneurysms are rare clinical entities and their certain prevelance and clinical significance are not well known. It can occur as a result of spontaneous closure of a pre-existing ventricular septal defect and the other etiologic factors consist of idiopathic formation, infection and trauma It should be noted that for a VSA, it is uncommon to exist in the absence of a known prior ventricular septal defect.
Case
An 35 year old female patient was consulted preoperatively to our outpatient clinic from department of general surgery by the reason of her previous aortic valve surgery. In detailed anamnesis it was found out that a correction procedure had been performed for the obstruction below the aortic valve when she was 17 years old. Her surgical operation reports demonstrated that she had undergone surgery for subaortic valvular stenosis and she had no control visits up to now. She defined that she had been complaining about palpitation for along time. In echocardiographic assessment membranous part of the interventricular septum was aneurysmatic towards the right ventricle. (Figure 1). There was an outward bulge of the basal interventricular septum during both systole and diastole with slightly reduced wall thickness. The aneurysm was free of thrombosis without ventricular septal defect. Color Doppler examination did not show any shunt flow between the ventricles. No accompanying ventricular septal defect was evident. Peak systolic pulmonary artery pressure estimated by the modified Bernoulli equation was 18 mmHg. In laboratory examination her tiroid hormone levels were high and the patient would already undergo surgery for toxic multinodular goitre. Tachycardia of the patient was considered to be due to the elevated thyroid hormone levels. Based on the hemodynamic stability of the patient and absence of any other symptoms, beta blocker therapy was started and she underwent surgery for toxic multinodular goiter. The patient maintained asymptomatic on medical follow-up.
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