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Left ventricular pseudo-false aneurysm perforating the right ventricle: two case reports
Hiroki Moriuchi1, Masaaki Koide2, Yoshifumi Kunii2
1Department of Cardiovascular Surgery, Seirei Hamamatsu Hospital, Shizuoka, Japan. porimori22@gmail.com.
Background:
Left ventricular (LV) pseudo-false aneurysm is a rare and fatal complication secondary to myocardial infarction. Sometimes, it may perforate the right ventricle (RV) and lead to acute heart failure. We experienced 2 cases of surgical repair of an LV pseudo-false aneurysm perforating the RV.
Case Presentation:
Case 1: A 76-year-old man was referred to our hospital due to dyspnea. Echocardiography revealed an LV pseudo-false aneurysm (25 mm × 20 mm) that had perforated the RV. Via LV incision, the two small orifices communicating to the RV were detected and closed by direct suture. A double patch of bovine pericardium and a dacron sheet was sutured around the aneurysm with everting mattress. Case 2: A 51-year-old man, who had undergone percutaneous coronary intervention 1 month before, was referred to our hospital due to an LV aneurysm perforating the RV. Via LV incision, a double-layered patch was sutured around the aneurysm with everting mattress. The communicating hole to RV was closed by bovine pericardium patch with a running suture via an RV incision. Postoperative course was uneventful in both cases.
Conclusions:
An LV pseudo-false aneurysm perforating the RV should be considered for urgent repair before serious complications arise and the patient's general condition deteriorates.
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