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[Rapidly enlarging giant left ventricular pseudo-false aneurysm after myocardial infarction; report of a case]

K Satoh1, S Kubota, K Kawakura

  • 1Department of Cardiovascular Surgery, National Hospital Organization, Hakodate, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 15, 2006
PubMed

Insights

A patient with myocardial infarction developed a pseudoaneurysm after treatment. Surgical repair successfully resolved the pseudoaneurysm, leaving a residual akinetic area.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Surgery

Background:

  • Acute myocardial infarction (AMI) complicated by cardiac tamponade requires urgent management.
  • Delayed intervention for AMI in patients with renal dysfunction presents unique challenges.
  • Cardiac tamponade following AMI can lead to hemodynamic instability.

Observation:

  • A 71-year-old male presented with AMI and cardiac tamponade, initially managed with pericardial drainage.
  • Emergent coronary angiography was deferred due to delayed presentation and severe renal dysfunction.
  • Transthoracic echocardiography revealed a giant posterior pseudoaneurysm prior to discharge.

Findings:

  • Percutaneous coronary intervention was performed after initial stabilization.
  • Surgical repair involving patch closure and coronary artery bypass grafting successfully addressed the pseudoaneurysm.
  • Histological examination confirmed a pseudo-false aneurysm, with residual akinetic posterior-inferior wall noted postoperatively.

Implications:

  • This case highlights the potential for pseudoaneurysm formation after myocardial infarction, even with delayed intervention.
  • Successful surgical management of large pseudoaneurysms is feasible, though functional deficits may persist.
  • Close echocardiographic monitoring is crucial for detecting delayed complications like pseudoaneurysms in post-MI patients.

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