Ventricular aneurysm: an angiographic study of 59 cases

Cine-coronary arteriography in 186 consecutive patients with coronary heart disease demonstrated 109 cases with transmural infarctions, among which 59 revealed ventricular aneurysm (true 57, false 2). Twenty-eight cases underwent aneurysmectomy and 1 autopsy was performed. The anterolateral wall and/or apex of the left ventricle were involved in all 57 true cases of ventricular aneurysm. Single, double and triple vessel diseases of the coronary arteries were found in 29/57 (50.9%), 11/57 (19.3%) and 13/57 (22.8%), respectively. The anterior descending artery (LAD) was involved in 53 of the 57 cases (92.9%). In two cases with false ventricular aneurysm, the postero-lateral wall of the left ventricle was involved in one and the right ventricular wall in the other. Single vessel disease of the right coronary artery and the left circumflex branch was found respectively in the two cases. The problems of angiographic diagnosis and differential diagnosis of the true and false ventricular aneurysm are discussed.