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Published on: September 9, 2020
[Successful Surgical Repair of a Pseudo-pseudo Left Ventricular Aneurysm Following Myocardial Infarction:Report of a
Daiki Sato1, Masato Nakajima, Ikumi Osawa
1Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Kofu, Japan.
Insights
This case report details a rare left ventricular pseudo-pseudoaneurysm, a complication following percutaneous coronary intervention. Surgical patch closure proved effective in managing this extremely rare cardiac condition.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- A 76-year-old woman experienced subacute myocardial infarction requiring percutaneous coronary intervention (PCI).
- Subsequent PCI addressed a residual lesion in the left anterior descending artery.
Purpose of the Study:
- To report a rare case of left ventricular pseudo-pseudoaneurysm.
- To highlight the effectiveness of surgical patch closure for this condition.
Main Methods:
- Diagnosis was made via transthoracic echocardiography showing an enlarged inferior wall bulge.
- Intraoperative findings confirmed a saccular aneurysm with a thin myocardial layer.
- Surgical intervention involved patch closure of the aneurysmal orifice.
Main Results:
- A left ventricular pseudo-pseudoaneurysm was identified and successfully treated.
- The patient experienced an uneventful postoperative recovery.
Conclusions:
- Left ventricular pseudo-pseudoaneurysm is an exceptionally rare cardiac pathology.
- Surgical patch closure is an effective treatment modality for this condition.
Abstract:
A 76-year-old woman underwent percutaneous coronary intervention (PCI) to the right coronary artery for subacute myocardial infarction six months earlier. Subsequently, PCI was also performed for a residual lesion in the left anterior descending artery. On follow-up transthoracic echocardiography, performed six months later, a localized bulging of the inferior wall of the left ventricle was observed, which had markedly enlarged compared to the previous study, leading to the decision for surgical intervention. Intraoperatively, there were no significant adhesions between the aneurysm and the pericardium. A saccular aneurysm was identified in the inferior wall of the left ventricle. A thin layer of myocardial tissue was observed beneath the epicardium, suggesting the diagnosis of a pseudopseudoaneurysm. The aneurysm was incised, and patch closure was performed at the aneurysmal orifice. The postoperative course was uneventful. Left ventricular pseudo-pseudoaneurysm is an extremely rare entity. We report this case to highlight the effectiveness of surgical patch closure in the management of this condition.
