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Clinical profile and management of post infarction left ventricular pseudoaneurysm
S Sharma1, K Mukherjee, A Trivedi
1Bombay Hospital and Medical Research Centre.
Insights
This study presents three cases of left ventricular pseudoaneurysm following myocardial infarction. Surgical repair proved successful, with all patients remaining asymptomatic post-treatment, highlighting effective intervention for this cardiac complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Left ventricular pseudoaneurysm (LVPA) is a rare but serious complication of myocardial infarction (MI).
- Prompt and accurate diagnosis is crucial for effective management.
- Surgical intervention is often necessary for successful outcomes.
Observation:
- Three patients with LVPA secondary to Q wave myocardial infarction (inferior and anterolateral) were identified.
- Echocardiography with Doppler colour imaging diagnosed one case.
- Left ventriculography provided definitive diagnosis in all three cases.
Findings:
- All three patients underwent successful surgical repair of the pseudoaneurysm defect.
- Two patients also received bypass grafting for diseased coronary vessels.
- Post-operative follow-up showed excellent results, with all patients asymptomatic at 18-30 months.
Implications:
- Left ventriculography is a reliable diagnostic tool for LVPA.
- Surgical repair, including patch closure and revascularization when indicated, leads to favorable long-term outcomes.
- Early diagnosis and surgical management are key to resolving LVPA and restoring patient health.
Abstract:
Three patients with left ventricular pseudoaneurysm are presented. Two patients had inferior and one had an anterolateral wall Q wave myocardial infarction. Echocardiography with Doppler colour imaging provided the diagnosis in one case, whereas the correct diagnosis was possible on left ventriculography in all. Successful surgery using patch closure of the defect in all patients and bypass grafting of the diseased coronary vessels was done in 2 cases. Angiographic follow-up in one case revealed excellent result and during 18 to 30 months of clinical follow-up, all patients are asymptomatic.