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Review
. 2009 Feb 24:4:11.
doi: 10.1186/1749-8090-4-11.

Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature

Giampaolo Zoffoli  1 , Domenico Mangino, Andrea Venturini, Alberto Terrini, Angiolino Asta, Chiara Zanchettin, Elvio Polesel
Affiliations
Review

Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature

Giampaolo Zoffoli et al. J Cardiothorac Surg. .

Abstract

Rupture of the free wall of the left ventricle (LV) is a catastrophic complication occurring in 4% of patients after myocardial infarction (MI) and in 23% of those who die of MI. Rarely the rupture is contained by an adherent pericardium creating a pseudo-aneurysm. This clinical finding calls for emergency surgery. If no ruptures are detectable and myocardium wall integrity is confirmed, we are in the presence of a true aneurysm, which can be treated by means of elective surgery. Differentiation between these two pathologies remains difficult. We report the case of a patient with a true aneurysm, initially diagnosed as pseudo-aneurysm at our institution; we have reviewed the literature on this difficult diagnosis and outlined characteristic findings of each clinical entity.

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Figures

Figure 1
Figure 1
Left ventricular angiography. Left ventricular angiography showed an enlargement of the left ventricle with a large dyskinetic cavity localized in the diaphragmatic region, suggesting the presence of a pseudo-aneurysm.
Figure 2
Figure 2
Surgical time. A large true aneurysm of the posterior wall of the left ventricle was found.
Figure 3
Figure 3
The aneurysm was opened. The aneurysm consisted of a very thin myocardium layer, close to the mitral valve.
Figure 4
Figure 4
The thrombus. The thrombus inside was about 6 cm × 4.5 cm.
Figure 5
Figure 5
Dor's repair. The defect was closed, using the thin autologous aneurysmatic excised myocardium layer as patch.
Figure 6
Figure 6
Teflon pledgets. Two Teflon pledgets were used to reinforce the ventricle suture on the outside.
See this image and copyright information in PMC

References

    1. Pollak H, Nobis H, Miczoc J. Frequency of left ventricular free wall ruptures complicating acute myocardial infarction since the advent of thrombolysis. Am J Cardiol. 1994;74:184–86. doi: 10.1016/0002-9149(94)90098-1. - DOI - PubMed
    1. Dor V, Saab M, Coste P, Kornaszewska M, Montiglio F. Left ventricular aneurysm: a new surgical approach. Thorac Cardiovasc Surg. 1989;37:11–19. doi: 10.1055/s-2007-1013899. - DOI - PubMed
    1. Gueron M, Wanderman KL, Hirsch M, Borman J. Pseudo-aneurysm of the left ventricle after myocardial infarction. J Thorac Cadiovasc Surg. 1975;69:736–42. - PubMed
    1. Balakumaran K, Verbaan CJ, Essed CE, Nauta J, Bos E, Haalebos MM, Penn O, Simoons ML, Hugenholtz PG. Ventricular free wall rupture: sudden, subacute, slow, sealed and stabilised varieties. Eur Heart J. 1984;5:282–88. - PubMed
    1. Loop FD, Effler DB, Webster JS, Groves LK. Posterior ventricular aneurysm, etiologic factors and result of surgical treatment. N Eng J of Med. 1973;41:302–06. - PubMed