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Pseudoaneurysm of the left ventricle progressing from a subepicardial aneurysm

H Koito1, C Nakamura, J Suzuki

  • 1Second Department of Internal Medicine/Cardiovascular Center, Kansai Medical University, Moriguchi, Japan. koitoh@takii.kmu.ac.jp

Japanese Circulation Journal
|August 26, 1999
PubMed

Insights

A subepicardial aneurysm progressed to a large left ventricular pseudoaneurysm in a patient with myocardial infarction. Surgical repair was successful, indicating this condition is treatable.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • A 56-year-old male presented with inferior myocardial infarction and a rapidly growing left ventricular pseudoaneurysm.
  • The pseudoaneurysm developed from a pre-existing subepicardial aneurysm over six months.

Observation:

  • Multiple imaging modalities confirmed myocardial disruption at the pseudoaneurysm neck with abnormal systolic and diastolic blood flow.
  • Coronary angiography showed critical stenosis in the atrioventricular nodal branch of the right coronary artery.

Findings:

  • Surgical exploration revealed a 1.5-cm orifice between the left ventricle and the pseudoaneurysm, with the aneurysmal wall lacking myocardial tissue.
  • Pathological examination confirmed the absence of myocardial elements in the aneurysmal wall.

Implications:

  • Subepicardial aneurysms can progress to large, potentially rupturing pseudoaneurysms, posing a significant clinical risk.
  • Surgical intervention for such pseudoaneurysms is feasible and can lead to favorable outcomes.

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