True Aneurysm Research Articles

Mid-Term Results of Fenestrated Endovascular Repair after Prior Open Aortic Reconstruction.

This study aims to assess the mid-term results of fenestrated endovascular aneurysm repair (FEVAR) for the treatment of proximal aortic pathology after previous open surgical repair (OSR). All patients with a previous history of OSR of an abdominal aortic aneurysm undergoing a FEVAR procedure between October 2010 and November 2021 were included. The endpoints of the study were technical success, mortality, target vessel patency and reinterventions during follow-up. Thirty-five patients (34 male, mean age 72.9 ± 7 years) were included. The median interval from the primary surgery to the FEVAR procedure was 136 months (range 47–261). The indication for treatment was a para-anastomotic aneurysm in 18 (51%) patients and a true aneurysm due to progression of disease in 17 (49%) patients. Technical success was achieved in 33 (94%) patients. There was one (3%) early death due to postoperative bleeding from a renal artery. Estimated survival at 12, 24 and 36 months was 89.1% ± 6%, 84.4% ± 7.3% and 84.4% ± 7.3%, respectively. There was no aneurysm-related mortality. One (3%) target vessel occluded during follow-up and three (9%) patients underwent late reinterventions. In conclusion, FEVAR is a safe and effective alternative for the endovascular treatment of para-anastomotic aneurysms/pseudoaneurysms after OSR showing high technical success, low mortality and morbidity, and good mid-term outcomes.

Closure of a pseudo aneurysm developed after trauma in the brachial artery with endovascular stent graft: A case report

Aneurysm is defined as 50% enlargement of the normal diameter of the artery. The most common cause of true aneurysms is atherosclerosis. Pseudoaneurysms, on the other hand, occur as a result of the blood leaking from the tear in the arterial wall forming a thrombus formation and surrounding it with a fibrous capsule. In pseudoaneurysms, blood pools in a closed area. However, they may enlarge and rupture in the late period. Treatment options are thrombin injection, endovascular graft implantation, surgical ligation, and arterial bypass. In this case report, we present a patient with a stab wound to the axilla. Two years after the injury, a pseudoaneurysm developed in the left brachial artery. The pseudoaneurysm was treated with endovascular stent graft

Open and Endovascular Repair for Splenic Artery Aneurysm: 20-year Experience at Toronto General Hospital

Splenic artery aneurysms (SAAs) are uncommon aneurysms that have been diagnosed with increasing frequency during the past few years. The recently published Society for Vascular Surgery (SVS) clinical practice guidelines on the management of visceral aneurysms revised the previous recommended size threshold for repair of nonruptured true aneurysms from 2 cm to 3 cm and continued to recommend treatment of any SAAs diagnosed in women of childbearing age and any pseudoaneurysms. The purpose of the present study was to evaluate and analyze the data and outcomes of patients who had undergone open and endovascular repair of SAAs at Toronto General Hospital and compare the size threshold for repair with the recently reported SVS guidelines.

Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair

Purpose: The impact of preoperative patent inferior mesenteric artery (IMA) on late outcomes following endovascular aneurysm repair (EVAR) remains unclear. This study aimed to investigate the specific influence of IMA patency on 7-year outcomes after EVAR. Materials and Methods: In this retrospective cohort study, 556 EVARs performed for true abdominal aortic aneurysm cases between January 2006 and December 2019 at our institution were reviewed. Endovascular aneurysm repairs performed using a commercially available device with no type I or type III endoleak (EL) during follow-up and with follow-up ≥12 months were included. A total of 336 patients were enrolled in this study. The cohort was divided into the patent IMA group and the occluded IMA group according to preoperative IMA status. The late outcomes, including aneurysm sac enlargement, reintervention, and mortality rates, were compared between both groups using propensity-score-matched data. Results: After propensity score matching, 86 patients were included in each group. The median follow-up period was 56 months (interquartile range: 32–94 months). The incidence of type II EL at discharge was 50% in the patent IMA group and 19% in the occluded IMA group (p<0.001). The type II EL from IMA and lumbar arteries was significantly higher in the patent IMA group than in the occluded IMA group (p<0.001 and p=0.002). The rate of freedom from aneurysm sac enlargement with type II EL was significantly higher in the occluded IMA group than in the patent IMA group (94% vs 69% at 7 years; p<0.001). The rate of freedom from reintervention was significantly higher in the occluded IMA group than in the patent IMA group (90% vs 74% at 7 years; p=0.007). Abdominal aortic aneurysm–related death and all-cause mortality did not significantly differ between groups (p=0.32 and p=0.34). Conclusions: Inferior mesenteric artery patency could affect late reintervention and aneurysm sac enlargement but did not have a significant impact on mortality. Preoperative assessment and embolization of IMA might be an important factor for improvement in late EVAR outcomes. Clinical Impact The preoperative patency of the inferior mesenteric artery was significantly associated with a higher incidence of sac enlargement and reintervention with type II endoleak following endovascular aneurysm repair, even after adjustment for patient background. Preoperative assessment and embolization of inferior mesenteric artery might be an important factor for improvement in late EVAR outcomes.

True left ventricular aneurysm in acute myocardial infarction: immediate and long-term outcomes, prognostic factors, and treatment

An important place in the structure of cardiovascular morbidity is occupied by myocardial infarction (MI), especially complicated MI, including complicated by the formation of left ventricular (LV) aneurysm. The latter is a very formidable complication and leads to such life-threatening conditions as ventricular arrhythmias, heart failure, thromboembolism. The purpose of the review is to analyze the publications of foreign and Russian authors on risk factors, outcomes and treatment of patients with postinfarction LV aneurysm. Attention is paid to the role of registers in the study of this problem, as well as the analysis of literature data on the prevalence of such a complication as MI during the COVID-19 pandemic (COrona VIrus Disease 2019). It is shown that the registers of acute coronary syndrome, as a rule, do not contain separate data on patients with a formed LV aneurysm, risk factors for its development and outcomes in this group of patients. Postinfarction LV aneurysm can form only after transmural MI; therefore, it is important to keep records of patients diagnosed with transmural MI, primarily in the form of a register.

Myocardial Infarction With Ventricular Wall Aneurysm: A Case Report

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.

Successful Endovascular Management of a Massive Hemoptysis due to a Rare Oncological Giant Pulmonary Artery Pseudoaneurysm

Massive hemoptysis represents a distressing and life-threatening condition: 95% of cases originate from the bronchial artery system, with pulmonary arteries accounting for 6%–11% of cases. The most common etiology of hemoptysis from the pulmonary artery system is represented by pulmonary artery pseudoaneurysms (PAPs). PAPs are defined as the focal dilation of a pulmonary artery branch, involving only the adventice, with a higher risk of rupture than a true aneurysm. It constitutes a rare finding, often underdiagnosed by radiologists. However, PAPs can be life-threatening if undiagnosed due to a high mortality rate (50%). They frequently occur in patients affected by erosive inflammatory processes and necrotising infections of the lung or heart, but other etiological factors include trauma, vasculitis, neoplasia, pulmonary hypertension and Hughes–Stovin Syndrome. PAPs due to oncologic etiologies are rare. Among oncologic etiologies, the most frequent are represented by primary lung cancer rather than metastases. Today, CT angiography represents the imaging modality of choice; not only to establish diagnosis, but if performed with an appropriate timing of intravenous contrast, it also helps to plan therapy with an endovascular approach. In fact, endovascular treatment is the preferred therapeutic approach in managing hemoptysis due to PAPs, since a surgical approach is associated with a high risk of morbidity and mortality, especially in patients who are poor surgical candidates. In this article we report the case of massive hemoptysis due to an unusual giant PAP of the posterior lower branch of the right pulmonary artery, in a patient affected by pulmonary colliquated and confluent metastases, successfully treated by endovascular embolisation.

A Prospective Study Comparing the Three-Dimensional Rotational Angiography and Two-Dimensional Digital Subtraction Angiography in Evaluation of Brain Arteriovenous Malformations.

Complex angioarchitecture of brain arteriovenous malformations (BAVM) are often difficult to evaluate with standard imaging technique of digital subtraction angiography (DSA). These details are better provided by 3D rotational angiography (3D-RA). The aim of the study is to compare two-dimensional digital subtraction angiography (2D-DSA) and 3D rotational angiography in the evaluation of BAVM angiographic architecture. 2D-DSA and 3D-RA of 167 consecutive patients with BAVM were analyzed for arterial feeders, nidal patterns, and detection of flow-related aneurysms, arteriovenous fistulous components, venous drainage, and draining vein stenosis. 3D-RA detected a significantly higher number of aneurysms and draining venous stenoses (P < 0.001). The detected number of true intranidal aneurysms was significantly higher with 3D-RA (n = 94) vs 2D-DSA (n = 34) (P < 0.001). 2D-DSA has low sensitivity (43.1%) and specificity (73.4%) for detecting intranidal aneurysms. 3D-RA detected a significantly higher number (12.6%) of BAVM patients with feeding artery aneurysms as compared to 2D-DSA (8.4%), P value of 0.004. 3D-RA accurately depicted the distal course of dominant arterial feeders and fistulous sites in BAVMs. Direct arteriovenous communications were evident in 31.1% with 3D-RA, as compared to 2D-DSA (15%) with P value < 0.0001. A significantly higher number of draining vein stenosis was detected with 3D-RA (21.6%) as compared to 2D-DSA (13.2%), P value < 0.001. 3D-RA is better than 2D-DSA for detecting BAVM-associated flow-related aneurysms, distal course of the dominant arterial feeders, direct visualization of the fistulous components, deep venous drainage, and draining venous stenosis; findings imperative for making a prudent therapeutic decision.

ЛЕЧЕНИЕ ПОСТТРАВМАТИЧЕСКОГО РАССЛОЕНИЯ АОРТЫ ТИПА «В» У ПОДРОСТКА: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

Post-traumatic aortic dissection is one of the most dangerous, life-threatening clinical conditions that is rarely encountered in pediatric clinical practice. The article represents a case of post-traumatic aortic dissection in a teenager. A 14 years old male patient, M., had been admitted to the pediatric clinic of the Saint Petersburg State Pediatric Medical University (Saint Petersburg, Russia) on Dec. 29, 2020, with a preliminary diagnosis as follows: car accident injury, post-traumatic injury of the thoracic aorta with the formation of a true aneurysm in the initial section of the descending thoracic aorta. During the examination, the diagnosis was clarified towards post-traumatic type B aortic dissection. The damages to the ascending aorta and aortic arch were excluded. Within 48 hours after admission a single-stage hybrid surgical intervention was performed using advanced diagnostic algorithms in the form of 3D printing, as well as combined surgical treatment, which included endovascular intervention with previous carotid-subclavian bypass grafting, resulting in positive immediate and long-term clinical outcomes. The active surgical tactics minimized the likelihood of life-threatening complications that could affect the outcome of treatment in the observed case.

Aneurısmas arterıales de extremıdad superıor: etıología, manejo y resultado

Upper extremity arterial aneurysms are not common clinical conditions. It may causes ischemic gangrene or limb losses as a result of thromboembolic events due to endothelial damage. In this study, we aimed to investigate the etiology, management, and long-term outcome. A total of 55 upper extremity aneurysms between January 2009 and April 2018 were retrospectively investigated. The mean age was 41 ± 13 years, and the women and men were 13 (23.6%) and 42 (76.4%). The mean follow-up was 43 ± 18 months. The incidence of pseudoaneurysm was higher than the true aneurysm (64.5% vs. 35.5%). 30 (84%) patients who had pseudoaneurysm repaired primerely and 6 (16%) patients had patchplasty. About 58% of the true aneurysm caused by blunt trauma. 4 (21%) true brachial aneurysm patients were required emergency intervention due to distal ischemia. 16 (84.2%) patients operated using by saphenous vein graft. The primary and secondary patency was 87.5% and 93.8%. No limb or life loss occurred during follow-up. Pseudoaneurysms are more common among upper limb aneurysms and they occur mostly by iatrogenic causes. Blunt trauma can be main cause of the true aneurysm. Surgical resection of the aneurysm and interposition of saphenous vein graft provides excellent results in the long-term.

Silk Vista Baby for the Treatment of Complex Posterior Inferior Cerebellar Artery Aneurysms.

Treatment of small-caliber vessel lesions using flow diverters remains challenging because of vasculature's narrow luminal diameter and tortuosity. This in turn makes navigation and delivery of conventional devices with standard microcatheters more difficult. The Silk Vista Baby (SVB, Balt) flow diversion device was designed for ease of use in vessels with a smaller diameter, distal lesions, and 0.017 ″ microcatheter delivery systems. To report the outcomes of the SVB device on the treatment of posterior inferior cerebellar artery (PICA) aneurysms. Databases from different centers were retrospectively reviewed for PICA aneurysms treated with SVB. Demographic information, clinical presentation, radiographic characteristics, procedural complications, and immediate postprocedure outcomes were obtained. Fourteen patients harboring 15 true PICA aneurysms were treated between January 2019 and June 2021. Nine were female (n = 9/14; 64.2%), and the mean age was 51 ± 14.9 years. Most patients had previously ruptured aneurysms, treated by another endovascular technique. Six aneurysms were located distally (n = 6/15; 40%). The mean neck size was 3 mm (SD 1.35, range 2.5-5 mm), whereas the mean PICA diameter was 1.6 mm (SD 0.26, range 1.5-1.7 mm). The mean length of follow-up was 6 months (SD 8.28, range 4.5-16 months). Treatment-related adverse events included 1 case of transient hypoesthesia. Two additional events were reported, but adjudicated as unrelated to the procedure. Complete occlusion, measured as Raymond-Roy class I, was achieved in all cases. The SVB device was safely and effectively used in the treatment of PICA aneurysms. The smaller delivery system profile reduces the risk of procedure complications and creates new treatment options for distal lesions.

CT-Based Analysis of Left Ventricular Hemodynamics Using Statistical Shape Modeling and Computational Fluid Dynamics.

BackgroundCardiac computed tomography (CCT) based computational fluid dynamics (CFD) allows to assess intracardiac flow features, which are hypothesized as an early predictor for heart diseases and may support treatment decisions. However, the understanding of intracardiac flow is challenging due to high variability in heart shapes and contractility. Using statistical shape modeling (SSM) in combination with CFD facilitates an intracardiac flow analysis. The aim of this study is to prove the usability of a new approach to describe various cohorts.Materials and MethodsCCT data of 125 patients (mean age: 60.6 ± 10.0 years, 16.8% woman) were used to generate SSMs representing aneurysmatic and non-aneurysmatic left ventricles (LVs). Using SSMs, seven group-averaged LV shapes and contraction fields were generated: four representing patients with and without aneurysms and with mild or severe mitral regurgitation (MR), and three distinguishing aneurysmatic patients with true, intermediate aneurysms, and globally hypokinetic LVs. End-diastolic LV volumes of the groups varied between 258 and 347 ml, whereas ejection fractions varied between 21 and 26%. MR degrees varied from 1.0 to 2.5. Prescribed motion CFD was used to simulate intracardiac flow, which was analyzed regarding large-scale flow features, kinetic energy, washout, and pressure gradients.ResultsSSMs of aneurysmatic and non-aneurysmatic LVs were generated. Differences in shapes and contractility were found in the first three shape modes. Ninety percent of the cumulative shape variance is described with approximately 30 modes. A comparison of hemodynamics between all groups found shape-, contractility- and MR-dependent differences. Disturbed blood washout in the apex region was found in the aneurysmatic cases. With increasing MR, the diastolic jet becomes less coherent, whereas energy dissipation increases by decreasing kinetic energy. The poorest blood washout was found for the globally hypokinetic group, whereas the weakest blood washout in the apex region was found for the true aneurysm group.ConclusionThe proposed CCT-based analysis of hemodynamics combining CFD with SSM seems promising to facilitate the analysis of intracardiac flow, thus increasing the value of CCT for diagnostic and treatment decisions. With further enhancement of the computational approach, the methodology has the potential to be embedded in clinical routine workflows and support clinicians.

Idiopathic Radial Artery True Aneurysm

True idiopathic radial artery aneurysm is a rare entity. There are only a few cases reported in the literature. Asymptomatic radial arterial aneurysm in young patients is even rarer. Here, we present a successfully managed case report of a left radial artery aneurysm in a young female who presented to us with a painless, pulsatile swelling at the wrist.

ANEURYSM OF SPLENIC ARTERY. INCIDENCE, CLINIC, DIAGNOSIS, TREATMENT. REVIEW AND CASES FROM PRACTICE

Aneurysms of splenic artery are the most common visceral aneurysms. There are true aneurysms and pseudoaneurysms. True aneurysms develop against the background of artery wall weakness. Pseudoaneurysms result from a rupture of the intima of the vessel wall with subsequent dissection of blood into a false lumen and formation of a periarterial hematoma. They are detected as an incidental finding without any clinical manifestation. The aim of this article is to present two clinical cases of a ruptured aneurysm of the splenic artery in our practice. The mortality rate after rupture of the splenic artery aneurysm varies from 25% to 40%. Under emergency conditions, the time for diagnosis is scarce and limited by the hemodynamic status of the patient. With increasing the possibilities of diagnostic imaging, the chances for minimally invasive treatment of incidentally detected pseudoaneurysms of the splenic artery improve. The conditions for successful management of this pathology include organization of emergency surgical care and collaboration between surgical teams.

Microsurgical Approach for True Posterior Communicating Artery Aneurysms: Literature Review and Illustrative Case.

True posterior communicating artery (PCoA) aneurysms are rare. Although true PCoA aneurysms have been reported to be located close to the internal carotid artery, at the middle part of PCoA, or close to the posterior cerebral artery; the best surgical approach to treat true PCoA aneurysms in each location remains unclear. We conducted a literature review using data from PubMed. Data on demographics, location, and projecting direction of the aneurysm, surgical approach, and surgical complications were collected. A total of 47 true PCoA aneurysms were included. Twenty-nine aneurysms originated from the proximal portion, 10 from the middle portion, and 6 from the distal portion; there were two giant aneurysms. The ipsilateral pterional approach was used for 37 true PCoA aneurysms (27 in proximal portion, 8 in middle portion, and 2 in distal portion of PCoA). The anterior temporal approach was used for two distal-portion aneurysms and one giant aneurysm. The anterior subtemporal approach was used for one distal-portion aneurysm. The subtemporal approach was used for two middle-portion aneurysms and one giant aneurysm. The contralateral pterional approach was used for two proximal-portion and one distal-portion aneurysms. Although most true PCoA aneurysms can be treated by the pterional approach, other means such as anterior temporal and subtemporal approaches can be applicable for aneurysms in the middle and distal portions of the PCoA or giant aneurysms. Surgeons should select an appropriate approach for each aneurysm while considering the advantages and disadvantages of each technique.

Visceral artery aneurysmal lesion of the omentum – a rare cause of spontaneous fatal intra-abdominal hemorrhage

We report unexpected death of a 72-year-old man due to a hemoperitoneum (1.9 L of blood in the abdominal cavity). Postmortem examination revealed that the cause of the hemorrhage was an arterial aneurysmal lesion in the greater omentum. The lesion measured 4 × 4 × 6 cm with a generally smooth wall, but with a focal area of rupture within a hemorrhagic region measuring 1 × 2 cm. There was a substantial feeding artery. Histological examination revealed features in keeping with a pseudoaneurysm, but also with some features of a true aneurysm. There was no history of trauma and the rupture of the aneurysmal lesion that had caused the hematoperitoneum was considered to be spontaneous. Prior to his death the deceased had attended hospital for epigastric pain, which was attributed to dyspepsia, but otherwise he had not had symptoms prior to his death.

Natural History of Renal Artery Aneurysms

Natural History of Renal Artery Aneurysms

Snuff box radial artery aneurysm: A case report and literature review.

Introduction and importanceDistal radial artery aneurysms in the anatomical snuff box are rare.Case presentationHerein, we present the case of a snuff box radial artery aneurysm in a female patient with a possible history of trauma and discuss the evaluation and management of snuff box radial artery aneurysms. The aneurysm in this case was resected without reconstruction because of a normal preoperative Allen test finding and intraoperative evidence of adequate hand perfusion after the aneurysm was excised. The patient subsequently recovered with proper hand function.Clinical discussionRadial artery aneurysms cases are rare; literature search by us and others have identified only 20 cases. For the detection and management of aneurysm, several high-end techniques may be employed; however, in this case, we employed non-invasive ultrasound method. The method is non-invasive and accurately delineates and localises an aneurysm, differentiates true arterial aneurysms from pseudoaneurysms, and identifies the presence of a mural thrombus. Further, the ultrasound assessments also help surgeons on requirement of radial artery reconstruction.ConclusionIn this case report, an anatomical snuff box radial artery aneurysm was surgically excised without reconstruction. Physical examination and Doppler ultrasound findings were employed to assess the medical condition of the patient; patient's proper hand function was restored.

Surgical treatment of acute aortic dissection in a patient with SLE and prior antiphospholipid syndrome on therapy for over 30 years: a case report

BackgroundIn patients with systemic lupus erythematosus (SLE), lengthy treatment and long-term steroid use are the main risk factors for developing aortic aneurysms or aortic dissections. In patients with cardiac tamponade, hemodynamic collapse may lead to acute renal and hepatic failure.Case presentationWe report the successful treatment of a 55-year-old woman with SLE since the age of 21. She suddenly felt chest pain approximately 2 weeks before developing fever and vomiting and was admitted to our hospital. Initially, she had severe liver dysfunction and was admitted to the hepatology department, where treatment for fulminant hepatitis was initiated. However, computed tomography (CT) showed an acute aortic dissection (DeBakey type II) and severe bloody pericardial effusion. Therefore, we performed emergency pericardial drainage. Plasma exchange therapy was initiated as emergency aortic surgery was deemed impossible due to impaired liver function tests and coagulation. Ten days later, the patient developed peritonitis due to small bowel perforation, and laparotomy was performed for abscess drainage and perforation closure. She had received steroid pulse therapy at the age of 21. At 40 years of age, she developed deep vein thrombosis due to antiphospholipid antibodies and was prescribed prednisolone. She was ambulatory at 3 months after the onset of acute aortic dissection, and CT revealed a rapidly enlarging true aneurysm in the distal arch. We performed elective aortic surgery. Although there were no antiphospholipid antibodies, surgery could have led to a devastating antiphospholipid syndrome. Therefore, we decided to treat the patient with triple therapy. Methylprednisolone was intravenously administered intraoperatively and at 1 day postoperatively. The patient was discharged without complications after returning to her usual oral prednisolone regimen.ConclusionsThe patient described herein had a systemic circulatory failure due to cardiac tamponade, accompanied by liver failure. This condition is a significant cause of death in patients with aortic dissection-associated SLE and is extremely dangerous. However, multi-specialty intervention helped the patient recover, and she has been attending the outpatient clinic. Aortic surgery requiring hypothermia in SLE patients with antiphospholipid syndrome and a history of thrombocytopenia or thrombosis requires a multi-disciplinary treatment team, including cardiac surgeons and medical experts.

Left ventricular pseudoaneurysm: the niche of post-infarction mechanical complications.

Left ventricular pseudoaneurysm (LVP) is a very rare, but potentially lethal mechanical complication of acute myocardial infarction (AMI). Despite representing a unique subset of cardiac rupture, it presents peculiar features that distinguish it from both ventricular free-wall rupture (FWR) and ventricular true aneurysm. LVP occurs in less than 0.5% of patients affected by AMI. However, LVP is generally burdened by high mortality, often related to false cavity rupture, leading to catastrophic and often irreversible consequences. The risk of rupture is inversely proportional to the timing from AMI onset, which also determines both the classification of LVP and drives the indication for treatment. Despite the lack of a current consensus on LVP management, urgent surgery is the treatment of choice for LVPs occurring within 3 months from AMI, especially if larger than 3 cm in diameter. A matter of debate, however, is represented by chronic LVPs, especially because the risk of rupture decreases progressively as time passes and left ventricular (LV) false cavity stabilizes. Surgical mortality rate remains not negligible (more than 20%), but these suboptimal results may be considered acceptable, especially considering the lethality associated with the occurrence of pseudoaneurysm rupture. Diagnostic workup is essential for anatomical characterization of LV rupture, which is mandatory to guide the decision on surgical approach and technique for pseudoaneurysm repair. Finally, for a subset of patients with anterior LVP and a well-defined fibrotic neck, and deemed at excessively high surgical risk, percutaneous closure of the cavity has been described with encouraging results.