Left ventricular pseudo-false aneurysm after ventricular septal dissection closure: a case report

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Left ventricular pseudo-false aneurysm is a rare complication following myocardial infarction, often stemming from intramyocardial dissecting hematoma.
• Ventricular septal perforation presents with an entry port in the left ventricle and an exit port in the right ventricle.

Purpose of the Study:

• To report a case of a large left ventricular pseudo-false aneurysm after surgical repair of ventricular septal dissection.
• To highlight the importance of secure closure of the left ventricular entry port during surgical repair.

Main Methods:

• A 72-year-old woman with ventricular septal perforation underwent initial sandwich patch repair via a right ventricular incision.
• Postoperative imaging revealed a large left ventricular pseudo-false aneurysm, necessitating a second surgery.
• The second surgery involved closing the entry port through the pseudo-false aneurysm with a Dacron patch.

Main Results:

• Initial surgical repair of ventricular septal perforation did not prevent pseudo-aneurysm formation.
• A large left ventricular pseudo-false aneurysm developed three months post-surgery, causing congestive heart failure.
• Successful closure of the left ventricular entry port during a second surgery resolved the pseudo-aneurysm.

Conclusions:

• Secure closure of the left ventricular entry port is critical in treating ventricular septal dissection after myocardial infarction.
• Sandwich patch repair via a right ventricular incision requires meticulous attention to the left ventricular entry port.
• Transmural mattress sutures with a large patch are recommended for securely closing the left ventricular entry port.