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Vukovic P, Okiljevic B, Micovic S, Zivkovic I. Surgical treatment of a left ventricular pseudoaneurysm with an extracellular matrix patch. Indian J Thorac Cardiovasc Surg 2024; 40:381-383. [PMID: 38681700 PMCID: PMC11045679 DOI: 10.1007/s12055-023-01669-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 05/01/2024] Open
Abstract
Left ventricle pseudoaneurysm is a rare and life-threatening complication of myocardial infarction that is formed as a result of left ventricle free wall rupture contained by the overlying pericardium. Urgent surgical repair is crucial, and in most reports, left ventricle was reconstructed with a Dacron or bovine pericardial patch. We present a case of a 66-year-old female with left ventricle pseudoaneurysm which was successfully repaired with an extracellular matrix patch. Supplementary Information The online version contains supplementary material available at 10.1007/s12055-023-01669-3.
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Affiliation(s)
- Petar Vukovic
- Clinic for Cardiac Surgery, Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bogdan Okiljevic
- Clinic for Cardiac Surgery, Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia
| | - Slobodan Micovic
- Clinic for Cardiac Surgery, Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor Zivkovic
- Clinic for Cardiac Surgery, Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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2
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Rumbinaitė E, Venckus V, Mamedov A, Jakuškaitė G, Bučius P, Dobilienė O, Žaliūnas R, Jakuška P, Benetis R. Anterior basal left ventricular pseudoaneurysm in a single vessel disease. Perfusion 2024; 39:849-853. [PMID: 36855313 PMCID: PMC11083744 DOI: 10.1177/02676591231160269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Left ventricular pseudoaneurysm is a rare but serious clinicopathologic entity. MATERIALS AND RESULTS This article describes a case report of 51-year-old man who experienced recurrence of chest pain and dyspnea 4 months later after anterior ST elevation myocardial infarction of first diagonal branch. Anterior basal left ventricular pseudoaneurysm was diagnosed and successful surgical treatment was performed. One year after operation, patient has no cardiovascular events and remains in NYHA class II. CONCLUSION Cardiac magnetic resonance should be performed, if there is a suspicion of left ventricular pseudoaneurysm from transthoracic echocardiography. Surgery is the treatment of choice in case of left ventricular pseudoaneuryms because untreated lesions carry a significantly high risk of rupture.
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Affiliation(s)
- Eglė Rumbinaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilius Venckus
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arslan Mamedov
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gabrielė Jakuškaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Paulius Bučius
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Olivija Dobilienė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Remigijus Žaliūnas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Jakuška
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rimantas Benetis
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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3
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Hanamura T, Fukamachi D, Tanaka M, Okumura Y. Asymptomatic left ventricular pseudoaneurysm. Clin Case Rep 2024; 12:e8599. [PMID: 38487647 PMCID: PMC10940004 DOI: 10.1002/ccr3.8599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 03/17/2024] Open
Abstract
Some cases of left ventricular pseudoaneurysms (LVPAs) are asymptomatic. While cardiac magnetic resonance imaging is important, a chest x-ray can easily be performed and is also crucial for the detection of LVPA during the first outpatient visit.
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Affiliation(s)
- Taisuke Hanamura
- Department of Cardiovascular SurgeryNihon University School of MedicineTokyoJapan
| | | | - Masashi Tanaka
- Department of Cardiovascular SurgeryNihon University School of MedicineTokyoJapan
| | - Yasuo Okumura
- Division of Cardiology, Department of MedicineNihon University itabashi HospitalTokyoJapan
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4
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Saeed M, Sabanci R, Martinez A, Kim AG, Prasad RM, Hanson C, Kehdi M. Post-myocardial Infarction Left Ventricular Aneurysm With Contained Rupture and Hemopericardium. Cureus 2024; 16:e56506. [PMID: 38646285 PMCID: PMC11026176 DOI: 10.7759/cureus.56506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
Left ventricular aneurysms (LVAs) represent a rare yet critical complication arising from late-presenting myocardial infarction (MI). Here, we present the case of an 88-year-old male with chest pressure, elevated troponin, B-type natriuretic peptide, and lactate. The electrocardiogram showed sinus tachycardia and an old right bundle branch block. The patient was started on heparin infusion, but progressively worsening hypotension necessitated transfer to the intensive care unit and the initiation of vasopressors. The echocardiogram identified a focal aneurysm in the mid-anterolateral wall, moderate pericardial effusion with a coagulum, and tamponade physiology. Computed tomography angiography of the chest confirmed a moderate pericardial effusion with density consistent with hemopericardium. LVAs pose a substantial threat of cardiovascular morbidity and mortality. While echocardiography serves as the initial assessment method, supplemental imaging modalities may need to be utilized. Various complications have been reported with LVA, including thromboembolization, ventricular arrhythmias, pericardial effusion with tamponade, and left ventricular rupture which accounts for 5%-24% of all in-hospital deaths related to MI. Although LVAs are the most common mechanical complications following an MI, instances of contained aneurysm rupture leading to hemopericardium are infrequent and scarcely reported. High clinical suspicion and prompt imaging with echocardiography are essential for diagnosis. Determining the optimal timing and selection between surgical and percutaneous interventions necessitates additional research for informed decision-making.
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Affiliation(s)
- Moiz Saeed
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Rand Sabanci
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Adolfo Martinez
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Andrew G Kim
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Rohan M Prasad
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Christopher Hanson
- Cardiology, Sparrow Hospital Thoracic and Cardiovascular Institute, Sparrow Hospital, Lansing, USA
| | - Michael Kehdi
- Cardiology, Sparrow Hospital Thoracic and Cardiovascular Institute, Sparrow Hospital, Lansing, USA
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5
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Kurdi M, Baranga L, Singh R, Scott J. Left ventricular pseudoaneurysm as a complication of LVAD explant. Radiol Case Rep 2024; 19:234-238. [PMID: 38028297 PMCID: PMC10630764 DOI: 10.1016/j.radcr.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Left ventricular (LV) pseudoaneurysms are a rare disease entity associated with a multitude of etiologies. We describe the radiographic findings of an LV pseudoaneurysm arising as a complication of a leaking left ventricular assist device (LVAD) closure device. Computed tomographic angiography (CTA) imaging demonstrated an apical LV wall defect with a preperitoneal collection of extravasated contrast. A review of the patient's surgical history revealed prior LVAD placement and explant with placement of an LV closure device. Familiarity with the radiologic manifestation of LV pseudoaneurysms is critical to establish a prompt diagnosis and facilitate timely therapeutic intervention.
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Affiliation(s)
- Mohanad Kurdi
- Kings County Hospital Center, 451 Clarkson Ave, Brooklyn, NY 11203 USA
- SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203 USA
| | - Latika Baranga
- Kings County Hospital Center, 451 Clarkson Ave, Brooklyn, NY 11203 USA
- SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203 USA
| | - Rohindeep Singh
- Kings County Hospital Center, 451 Clarkson Ave, Brooklyn, NY 11203 USA
- SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203 USA
| | - Jinel Scott
- Kings County Hospital Center, 451 Clarkson Ave, Brooklyn, NY 11203 USA
- SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203 USA
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6
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Tiruneh AG, Bekele A, Asrat Y, Tsegaye Q, Tesfaye W, Bezabih A. Successful repair of left ventricular rupture with pseudoaneurysm: a case report. J Surg Case Rep 2023; 2023:rjad444. [PMID: 37560604 PMCID: PMC10409564 DOI: 10.1093/jscr/rjad444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
Ventricular rupture with pseudoaneurysm is a rare phenomenon that usually occurs after myocardial infarction, previous cardiac surgery and infectious or inflammatory conditions. To prevent rupture of the pseudoaneurysm, urgent repair is recommended. We report successful open surgical repair of a 46-year-old man, who presented with pseudoaneurysm communicating with left ventricle.
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Affiliation(s)
- Abraham G Tiruneh
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Admikew Bekele
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yidnekachew Asrat
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Qaleab Tsegaye
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workneh Tesfaye
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Bezabih
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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7
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Naguib M, Elsayed M, Khouzam RN, Iskander A. Percutaneous Closure of Post-Infarct Left Ventricular Pseudoaneurysm; A Review of Literature. Curr Probl Cardiol 2023; 48:101743. [PMID: 37084993 DOI: 10.1016/j.cpcardiol.2023.101743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
Left ventricular pseudoaneurysm is a well-known complication of myocardial infarction and open-heart surgery and has recently been described as succeeding transapical transcatheter aortic valve replacement (TAVR). While surgical intervention is the conventional therapeutic approach, transcatheter closure can be considered in patients at high risk for surgical procedures. In this article, we present a post-myocardial infarction pseudoaneurysm for which closure was done via retrograde left ventricular (LV) access using an Amplatzer Septal Occluder, and provide a review of recent literature focusing on indications and outcomes of the different percutaneous techniques and devices.
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Affiliation(s)
- M Naguib
- Bachelor of Medicine and Bachelor of Surgery and Bachelor of Obstetrics, Roayl college of Surgeons in Ireland & North Lincolnshire and Goole NHS Trust Junior doctor.
| | - M Elsayed
- Bachelor of Medicine and Bachelor of Surgery and Bachelor of Obstetrics, Roayl college of Surgeons in Ireland & Southport at Osmskirk district hospital NHS Junior doctor
| | - R N Khouzam
- Consultant Interventional Cardiologist, Methodist Health Care
| | - A Iskander
- Doctor of Medicine, Consultant Interventional Cardiologist, St. Joseph's Hospital Cardiology Associates, St. Joseph's Health Hospital
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8
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Naseerullah FS, Pyle W, Addai T, Murthy A. Left ventricular pseudoaneurysm without antecedent myocardial infarction. J Cardiol Cases 2023. [DOI: 10.1016/j.jccase.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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9
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Pirzada A, Styles K, Stewart R. Massive left ventricular pseudoaneurysm presenting as dysphagia: a case report. Eur Heart J Case Rep 2023; 7:ytac495. [PMID: 36727138 PMCID: PMC9879834 DOI: 10.1093/ehjcr/ytac495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/26/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023]
Abstract
Background Left ventricular pseudoaneurysm is a recognized, however, uncommon presentation of acute myocardial infarction in the current era. This is due to early reperfusion therapy for acute myocardial infarction. Left ventricular pseudoaneurysm after myocardial infarction can present in a variety of ways, including heart failure, chest pain, and dyspnoea. Case summary We present a case of a 61-year-old male who presented with extremely atypical symptoms of dysphagia and weight loss due to a massive left ventricular pseudoaneurysm. Transthoracic echocardiogram and computed tomography revealed a large pseudoaneurysm causing mass effect on multiple gastrointestinal organs. Organic causes for dysphagia and weight loss were ruled out by gastroscopy. Surgical management was carried out but was ultimately unsuccessful. Discussion Despite the heterogeneity in presentation for patients with left ventricular pseudoaneurysm, rapid diagnosis is important for management and prognosis. Diagnostic tools include transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging. Management is usually surgical; however, there is some debate in the literature regarding conservative vs. surgical management for chronic pseudoaneurysms. More data are needed to determine optimal management strategies and prognosis for patients with left ventricular pseudoaneurysms.
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Affiliation(s)
- Ashar Pirzada
- Corresponding author. Tel: +1 902 473 7044, Fax: +1 902 473 2434,
| | - Kim Styles
- Division of Cardiology, Department of Medicine, Dalhousie University, 1796 Summer St, Room 2132, Halifax Infirmary, Halifax, NS B3H 3A7, Canada
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10
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Shuai X, Hu X, Wei Y. Case report: Spontaneous closure of ventricular pseudoaneurysm post-acute myocardial infarction with non-surgical therapy. Front Cardiovasc Med 2022; 9:996072. [PMID: 36204582 PMCID: PMC9530630 DOI: 10.3389/fcvm.2022.996072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Left ventricle (LV) pseudoaneurysm is a rare disorder post-acute myocardial infarction (AMI). Resection or closure of the pseudoaneurysm by surgery is recommended due to the high propensity of pseudoaneurysm rupture while surgery has also high risks. Conservative therapy could be acceptable in small pseudoaneurysms or patients with high surgical risks. Nevertheless, the risk evaluation and grasp of indication are not clear. This case reported an acute cyst-like LV pseudoaneurysm formation post-AMI-induced myocardial free wall rupture (MFWR), and the patient recovered with spontaneous closure of the fissure and shrinkage of the LV pseudoaneurysm through non-surgical therapy. Based on the observations in the echocardiogram, we proposed that intermittent closing of the fissure and interruption of the blood flow between the LV and the pseudoaneurysm due to LV contraction alleviated stress change on the pseudoaneurysm. The narrow fissure, small pseudoaneurysm, and intermittently interrupted blood flow that benefit fissure healing and pseudoaneurysm stabilization could indicate the prognosis of this patient. Drugs like β-blocker that decreased the stress on the pseudoaneurysm also led to the risk reduction of pseudoaneurysm rupture. To our knowledge, this is the first case that reports a spontaneous closure of LV pseudoaneurysm. The size of the fissure and the pseudoaneurysm, as well as the corresponding hemodynamic state, could be valuable to evaluate the risk and prognosis of the pseudoaneurysm. Optimized medical management was also helpful to pseudoaneurysm stabilization.
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11
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Meshram R, Vaibhav V, Agrawal S, Khorwal G, Sharma K. Myocardial Infarction With Ventricular Wall Aneurysm: A Case Report. Cureus 2022; 14:e29017. [PMID: 36237811 PMCID: PMC9551642 DOI: 10.7759/cureus.29017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2022] [Indexed: 11/05/2022] Open
Abstract
A ventricular aneurysm can be pseudo or true; it is a rare complication of myocardial infarction induced by an intra-myocardial dissecting hematoma due to fragile myocardium. Ventricular wall rupture takes place two to four days after myocardial infarction when coagulative necrosis and inflammatory infiltrate and lysis of myocardial connective tissue results in weakening of infarcted myocardium. Acute cardiac wall ruptures are mostly fatal; an unwittingly located pericardial adhesion can abort a rupture resulting in a false aneurysm. The wall of a false aneurysm consists of the epicardium in contrast to a true aneurysm, which is composed of the myocardium. True aneurysms are complications seen in transmural infarcts. Thinned-out scar tissue paradoxically bulged during systole, and toughened fibrotic wall rupture doesn't usually occur. Deaths in subjects with true ventricular aneurysms occur due to mural thrombus, arrhythmias, and heart failure. We encountered a case of a true aneurysm, as reported below.
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12
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Hang D, Iqbal Z, Gebrehiwot Y, Schena S, Joyce LD, Almassi GH, Pagel PS. Multilobular Structure Near the Left Ventricular Apex: Pericardial Effusion or a More Sinister Pathology? J Cardiothorac Vasc Anesth 2022; 36:3982-3985. [PMID: 35786349 DOI: 10.1053/j.jvca.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Dustin Hang
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.
| | - Zafar Iqbal
- Anesthesia Service and the Cardiothoracic Surgery Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | - Yizez Gebrehiwot
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI
| | - Stefano Schena
- Anesthesia Service and the Cardiothoracic Surgery Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI; Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Lyle D Joyce
- Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - G Hossein Almassi
- Anesthesia Service and the Cardiothoracic Surgery Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI; Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Paul S Pagel
- Anesthesia Service and the Cardiothoracic Surgery Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
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13
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Ventricular pseudoaneurysm rupture - a potentially fatal complication of myocardial infarction. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2020; 16:512-513. [PMID: 33598030 PMCID: PMC7863841 DOI: 10.5114/aic.2020.101781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022] Open
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14
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Sitta J, Howard CM. Left ventricular pseudoaneurysm: An unexpected finding. Radiol Case Rep 2020; 16:538-542. [PMID: 33384752 PMCID: PMC7770450 DOI: 10.1016/j.radcr.2020.12.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/19/2022] Open
Abstract
A left ventricle pseudoaneurysm (LV PSA) is defined as a free wall rupture of the left ventricle contained by the adjacent pericardial tissue. This rare complication is most commonly encountered following myocardial infarction, trauma, or infection. Surgery is typically warranted to avoid progression to spontaneous rupture, which may potentially lead to cardiac tamponade and death. Cardiac magnetic resonance imaging is the modality of choice to characterize left ventricle morphology and function. Accurate distinction between a pseudoaneurysm and a true aneurysm is crucial, since management and prognosis are significantly different between these 2 entities. We present a case of a 63-year-old male heart transplant recipient, admitted for suspicion of acute cellular rejection, with an unexpected finding of a LV PSA.
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15
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Arnaz A, Akansel S, Yalcinbas Y, Saygili A, Sarioglu T. Transcatheter Closure of Left Ventricular Pseudoaneurysm After Mitral Valve Replacement. Ann Thorac Surg 2020; 110:e123-e125. [PMID: 31982444 DOI: 10.1016/j.athoracsur.2019.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/27/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
Left ventricular pseudoaneurysm (LVPA) is a rare but lethal complication of mitral valve replacement (MVR) or myocardial infarction. Early correction is necessary for patients with extensive and expanding LVPA. We report a transcatheter closure of LVPA after MVR. A 63-year-old woman presented with an LVPA 2 months after MVR. The repeated computed tomographic scan and transthoracic echocardiography showed enhancement of pseudoaneurysm. The LVPA was closed successfully with Amplatzer Vascular Plug using a transcatheter approach.
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Affiliation(s)
- Ahmet Arnaz
- Department of Cardiovascular Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
| | - Serdar Akansel
- Department of Cardiovascular Surgery, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey
| | - Yusuf Yalcinbas
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Arda Saygili
- Department of Pediatric Cardiology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tayyar Sarioglu
- Department of Cardiovascular Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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16
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Caldeira A, Albuquerque D, Coelho M, Côrte-Real H. Left Ventricular Pseudoaneurysm: Imagiologic and Intraoperative Images. Circ Cardiovasc Imaging 2019; 12:e009500. [PMID: 31766861 DOI: 10.1161/circimaging.119.009500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Alexandre Caldeira
- Department of Anaesthesiology (A.C., D.A., M.C.), Centro Hospital Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - Diogo Albuquerque
- Department of Anaesthesiology (A.C., D.A., M.C.), Centro Hospital Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - Marta Coelho
- Department of Anaesthesiology (A.C., D.A., M.C.), Centro Hospital Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - Hugo Côrte-Real
- Department of Intensive Care Medicine (H.C.-R.), Centro Hospital Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
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17
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Oudin V, Moumen S, Tassan-Mangina S, Faroux L, Saade YA, Metz D. Un pseudo-anévrysme du ventricule gauche secondaire à des calcifications mitrales. Presse Med 2019; 48:989-991. [DOI: 10.1016/j.lpm.2019.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/07/2019] [Accepted: 07/23/2019] [Indexed: 12/01/2022] Open
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Antonic M, Djordjevic A, Mohorko T, Petrovic R, Lipovec R, Juric P. Left ventricular pseudoaneurysm following atrioventricular groove rupture after mitral valve replacement. SAGE Open Med Case Rep 2019; 7:2050313X18823456. [PMID: 30719310 PMCID: PMC6349977 DOI: 10.1177/2050313x18823456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 12/14/2018] [Indexed: 11/17/2022] Open
Abstract
Left ventricular pseudoaneurysm is a partial cardiac rupture, contained by the surrounding pericardium that maintains communication with the left ventricular lumen. Whereas most cases of left ventricular pseudoaneurysms are related to myocardial infarction (loss of myocardial integrity), only a handful are associated with valve surgery. We present a female patient, who was admitted for elective mitral valve replacement. After the implantation of the mechanical valve, we encountered a rupture of the atrioventricular groove. After 3 months, a left ventricular pseudoaneurysm was found and the patient was reoperated. The valve was explanted and the inspection of the annulus and previously implanted pericardial patch revealed a loosened stitch on the inferior (ventricular) side. The defect was reinforced with additional stitches and the valve was reimplanted. In conclusion, we report an unusual case with two serious complications after mitral valve replacement - atrioventricular groove rupture and left ventricular pseudoaneurysm.
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Affiliation(s)
- Miha Antonic
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
| | - Anze Djordjevic
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
| | - Tamara Mohorko
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
| | - Rene Petrovic
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
| | - Robert Lipovec
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
| | - Peter Juric
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
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Shimono H, Kajiya T, Inoue H, Ueno M, Takaoka J, Atsuchi Y, Atsuchi N, Ohishi M. Left Ventricular Pseudo-aneurysm with Ventricular Septal Rupture Due to Anterior ST-segment Elevation Myocardial Infarction. Intern Med 2019; 58:1901-1905. [PMID: 31257277 PMCID: PMC6663542 DOI: 10.2169/internalmedicine.2147-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case with the simultaneous occurrence of pseudo-aneurysm of the left ventricle and ventricular septal rupture, which was successfully surgically repaired. A 77-year-old woman with a history of aortic valve replacement and coronary bypass graft presented to our clinic due to chest pain. She was diagnosed with anterior ST-segment elevation myocardial infarction (STEMI) based on an electrocardiogram. Echocardiography revealed pseudo-aneurysm of the left ventricle and ventricular septal rupture. Coronary angiography revealed 99% stenosis with delayed contrast filling in the mid left anterior descending artery. Surgical repair with a bovine pericardium patch was performed, and the postoperative course was uneventful.
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Affiliation(s)
| | - Takashi Kajiya
- Department of Cardiology, Tenyoukai Central Hospital, Japan
| | - Hironori Inoue
- Department of Cardiovascular Surgery, Tenyoukai Central Hospital, Japan
| | - Masahiro Ueno
- Department of Cardiovascular Surgery, Tenyoukai Central Hospital, Japan
| | | | | | | | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Kagoshima University, Japan
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Cortese F, Costantino MF, Ciccone MM, Calculli G. A perforated cardiac pseudoaneurysm complicating an acute myocardial infarction. J Cardiovasc Med (Hagerstown) 2018; 19:756-757. [PMID: 30379753 DOI: 10.2459/jcm.0000000000000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Francesca Cortese
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari
| | - Marco Fabio Costantino
- Cardiology Intensive Care Unit, 'Alta Specialità del Cuore' Department, AORN San Carlo Hospital, Potenza
| | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari
| | - Giacinto Calculli
- Department of Cardiology, 'Madonna delle Grazie' Hospital, Matera, Italy
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Petrou E, Vartela V, Kostopoulou A, Georgiadou P, Mastorakou I, Kogerakis N, Sfyrakis P, Athanassopoulos G, Karatasakis G. Left ventricular pseudoaneurysm formation: Two cases and review of the literature. World J Clin Cases 2014; 2:581-586. [PMID: 25325071 PMCID: PMC4198413 DOI: 10.12998/wjcc.v2.i10.581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/21/2014] [Accepted: 07/29/2014] [Indexed: 02/05/2023] Open
Abstract
Left ventricular wall rupture (LVWR) comprises a complication of acute myocardial infarction (AMI). Acute LVWR is a fatal condition, unless the formation of a pseudoaneurysm occurs. Several risk factors have been described, predisposing to LVWR. High index of suspicion and imaging techniques, namely echocardiography and computed tomography, are the cornerstones of timely diagnosis of the condition. As LVWR usually leads to death, emergency surgery is the treatment of choice, resulting in significant reduction in mortality and providing favorable short-term outcomes and adequate prognosis during late follow-up. Herein, we present two patients who were diagnosed with LVWR following AMI, and subsequent pseudoaneurysm formation. In parallel, we review the aforementioned condition.
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