Posterobasal left ventricular aneurysms: clinical results and surgical treatment

Of 152 left ventricular aneurysms that occurred after infarction and were treated surgically, eight were located in the posterobasal segment. All of them were true aneurysms. Combined procedures, performed at the time of the aneurysm resection, included mitral valve replacement (two patients), coronary artery bypass grafting (five patients), closure of an interventricular septal defect (one patient), and carotid artery endarterectomy (one patient). Four had slight mitral regurgitation that disappeared after resection of the aneurysm, and two exhibited severe mitral regurgitation that required mitral valve replacement. Six patients survived operation and are free of symptoms. The literature shows a high incidence of false aneurysms that have a propensity toward rupture in this anatomical location. At times, there are difficulties in the differential diagnosis of true and false aneurysms and, consequently, we recommend an aggressive surgical approach.