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Delayed traumatic left ventricular pseudoaneurysm: diagnostic challenges and surgical management.
Rahul Bhushan1, Arun Kengalapura Ramesh1, Vijay Grover1
1Department of CTVS, ABVIMS and Dr RML Hospital, New Delhi, 110001 India.
Indian Journal of Thoracic and Cardiovascular Surgery
|August 19, 2024
Summary
A rare traumatic left ventricular (LV) pseudoaneurysm, presenting two years after blunt chest trauma, was successfully managed. This case highlights the importance of imaging for early detection and surgical intervention in patients with delayed cardiac trauma complications.
Area of Science:
- Cardiology
- Trauma Surgery
- Medical Imaging
Background:
- Left ventricular (LV) pseudoaneurysms are rare cardiac conditions, with traumatic etiologies being exceptionally uncommon.
- Delayed presentations of traumatic LV pseudoaneurysms, occurring years after the initial injury, pose diagnostic challenges.
Purpose of the Study:
- To report a unique case of a delayed traumatic LV pseudoaneurysm in a young adult.
- To discuss the diagnostic modalities and successful surgical management of this rare condition.
Main Methods:
- A 26-year-old male presented with dyspnea 2 years after blunt chest trauma.
- Diagnostic workup included X-ray, echocardiogram, and cardiac computed tomography (CT).
- Surgical intervention involved closure of the communicating orifice and pericardial patch placement.
Main Results:
- Imaging revealed a large LV pseudoaneurysm at the apex with intramural thrombus.
- The patient's dyspnea (New York Heart Association grade 2) resolved post-surgery.
- A favorable outcome was achieved through prompt diagnosis and intervention.
Conclusions:
- Traumatic LV pseudoaneurysms require a high index of suspicion, especially in patients with a history of chest trauma.
- Multimodality imaging is crucial for accurate diagnosis.
- Surgical repair offers a successful treatment strategy, emphasizing the need for a multidisciplinary approach.
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