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Left ventricular pseudo-false aneurysm perforating into the right ventricle.

Takahiro Inoue1, Kazuhiro Hashimoto2, Ko Bando2

  • 1Department of Cardiac Surgery, The Jikei University, Minato-ku, Tokyo, Japan yokosuka-inoten@jikei.ac.jp.

Interactive Cardiovascular and Thoracic Surgery
|April 19, 2015
PubMed
Summary

Left ventricular pseudo-false aneurysms are rare heart complications. This case highlights a large aneurysm perforating into the right ventricle, emphasizing the need for long-term patient monitoring after myocardial infarction.

Keywords:
Left ventricleMyocardial infarctionPseudo-false aneurysmRight ventricle

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Complications

Background:

  • Left ventricular pseudo-false aneurysms are infrequent but serious complications following myocardial infarction.
  • These aneurysms can present with symptoms mimicking ventricular septal defects and may lead to heart failure or fatal rupture.
  • Late mechanical complications of left ventricular remodeling necessitate thorough patient evaluation.

Observation:

  • A 67-year-old male developed a large left ventricular pseudo-false aneurysm post-myocardial infarction.
  • The aneurysm perforated into the right ventricle, a rare but serious event.
  • The patient had a history of percutaneous coronary intervention for coronary artery disease.

Findings:

  • Surgical repair involved direct closure of the right ventricular perforation and bovine pericardial patch for the left ventricular defect.
  • The patient presented late after the initial myocardial infarction event.
  • The pseudo-aneurysm was successfully managed surgically.

Implications:

  • This case underscores the importance of long-term surveillance for patients with transmural myocardial infarction.
  • Late mechanical complications, including pseudo-aneurysm formation and rupture, can occur despite successful revascularization.
  • Vigilant follow-up is crucial for managing left ventricular remodeling and preventing adverse events.