Ventricular Pseudoaneurysm Research Articles

Left Ventricular Apical Pseudoaneurysm: A Case Report Incidental Diagnosis and Management

Left ventricular pseudoaneurysm (LVPA) is a rare and life-threatening condition characterized by “an outpouching resulting from a rupture in the ventricular free wall.” We present a case with a history of myocardial infarction and left ventricular (LV) apical thrombus who presented with worsening dyspnea. Echocardiography revealed LVPA with bidirectional flow, confirmed by cardiac CT. He underwent successful surgical repair of LVPA and coronary artery bypass grafting. LVPA is associated with significant morbidity and mortality, so early diagnosis is crucial. This case report highlights the successful management of LVPA, underscoring the importance of prompt diagnosis and multidisciplinary care.

Contemporary experience of percutaneous management of complex aortic and ventricular pseudoaneurysms associated to perivalvular leak: A case series and review of literature

BackgroundPercutaneous closure of aortic and ventricular pseudoaneurysms (PSA) has only been reported on a case report and series basis. In previous case reports, percutaneous closure has been performed successfully in patients of prohibitive surgical risk. This case series aims to show feasibility of percutaneous closure of aortic and ventricular pseudoaneurysm secondary to perivalvular leak (PVL) in a small patient population and the utility of multimodality imaging as an integral tool in procedural planning. This is the largest complex case series to date describing the feasibility and success rate of complex PSA closure, with a follow-up period of up to 4 years. Material and methodsWe performed institutional review and systemic literature review to identify all paravalvular leak cases with associated pseudoaneurysm formation for which a closure procedure was performed. Ten patients were identified. Pooled analysis for cases from institutional review (n = 10) and systemic literature review (n = 39) was performed. The success rate was 100 %. At 30-days, the mortality was 0 %. ConclusionIn paravalvular leak patients with subsequent pseudoaneurysm formation, exhaustive imaging evaluation is required for closure. However, it can be achievable with favorable rates of success.

A case report of percutaneous closure of left ventricular pseudoaneurysm

A case report of percutaneous closure of left ventricular pseudoaneurysm

Abstract 18676: Aneurysmectomy or No Aneurysmectomy - An Unknown Heart Failure Terrain

Case Report: A 40-year male with a history of traumatic inferoapical ventricular septal rupture after a motor vehicle accident status post patch repair and left ventricular thrombus on Rivaroxaban presented to the ED with hemoptysis. The patient on arrival was hemodynamically stable. CTA revealed a new 6.9 cm left ventricular pseudoaneurysm and an echocardiogram revealed an EF of 30% with a pseudoaneurysm involving the entire distal septum, lateral wall, and apex and a ventricular septal rupture into the intraventricular septum. Cardiac MRI revealed a pseudoaneurysm from the inferoseptal wall measuring 9.6 x 6.9 x 10.0 cm and a stroke volume of 123 mL. A right heart catheterization revealed no evidence of left-to-right shunting. Given heart failure with reduced ejection fraction in the setting of a pseudoaneurysm and the complexity of aneurysm repair, advanced heart failure and cardiothoracic surgery teams were consulted for conventional surgical and transplant evaluation. Due to social barriers, the patient was declined from transplant and ultimately proceeded with patch repair. Intraoperative echocardiography revealed a post-operative EF of 25%. Discussion: This case highlights the need for further data on pseudoaneurysms that are confounded with concurrent heart failure. For this patient, the concerns were for adequate stroke volume given the extent of the pseudoaneurysm and whether improvement in systolic function could be seen with repair or result in further decline. It was postulated that surgical repair would raise his effective stroke volume, and thus improve cardiac function. Postoperative EF changes could have been further explained by myocardial stunning during anesthesia or rapid changes in end-diastolic volume with aneurysmectomy altering Frank-Starling hemodynamics. With isolated case report data, further aneurysmectomy outcome characterization is thus imperative to guide advanced heart failure treatment and improve patient mortality.

Left ventricular pseudoaneurysm as a mechanical complication of acute myocardial infarction: a case report

Left ventricular pseudoaneurysm as a mechanical complication of acute myocardial infarction: a case report

Case of the Season: Gerbode Defect and Left Ventricular Pseudoaneurysm as Complications of Mitral Valve Replacement

Case of the Season: Gerbode Defect and Left Ventricular Pseudoaneurysm as Complications of Mitral Valve Replacement

Percutaneous closure of infantile postoperative left ventricular pseudoaneurysm exclusively under transthoracic echocardiography guidance.

Percutaneous closure of infantile postoperative left ventricular pseudoaneurysm exclusively under transthoracic echocardiography guidance.

Application of multicultural nursing in a patient with giant left ventricular pseudoaneurysm

Application of multicultural nursing in a patient with giant left ventricular pseudoaneurysm

Left ventricular pseudoaneurysm as a late complication of incomplete surgical stab wound repair, a case report

Objectives: Left ventricular pseudoaneurysm (LVP) is a rare but life-threatening condition caused by rupture of the free wall of the ventricle. The ventricular wall is surrounded by adherent pericardium and scar tissue, lacking myocardial tissue. In this case study, an 18-year-old man, experiencing syncope, shortness of breath, dizziness, and pleuritic chest pain (CP) was admitted to the emergency department. Five months earlier, he had a penetrating chest trauma that damaged the pericardium and ventricular wall and underwent a left thoracotomy. Transthoracic echocardiography (TTE) identified a large 10*10 cm pseudoaneurysm in the apicolateral region of the ventricle. Considering the confirmed diagnosis of delayed left ventricular pseudo aneurysm, surgical intervention was deemed necessary. The patient went under general anesthesia, and cannulation of the artery and femoral vein and cardiopulmonary bypass (CPB) were performed. Open heart surgery was then performed through a midline sternotomy to excise the LVP and repair the ventricles. After transfer to the intensive care unit and subsequent extubation, the patient was transferred to the surgical ward and discharged in good condition.
 Conclusions: This case report highlights the importance of timely diagnosis and appropriate treatment to save the lives of patients given the rapid spread observed in LVP cases.

In Utero Presentation of Left Ventricular Aneurysm.

Congenital left ventricular aneurysm, pseudoaneurysm, and diverticulum are rare entities. These diagnoses can be made pre- and/or postnatally. Although these entities overlap clinically and morphologically, important distinctions can allow for accurate diagnoses. Appropriate diagnosis can be imperative for risk stratification and guidance of prenatal and postnatal management. The case described in the present report highlights a challenging case of a fetal left ventricular aneurysm, management during the prenatal and postnatal periods, and important differentiating features from a ventricular diverticulum and pseudoaneurysm.

Left ventricular pseudoaneurysm after endoscopic mitral valve repair for active endocarditis.

A left ventricular pseudoaneurysm is a rare complication that can occur after infective endocarditis, possibly leading to serious complications such as cardiac tamponade, rupture and recurrent infective endocarditis. We report a case of a totally-endoscopic repair of a pseudoaneurysm after endoscopic mitral valve repair. A 48-year-old woman underwent endoscopic mitral valve repair for active infective endocarditis. A left ventricular pseudoaneurysm was found 2 weeks after the surgery. The pseudoaneurysm was repaired through a left thoracotomy with a totally endoscopic platform. The postoperative course was uneventful, and there was no recurrence at 18 months. Left ventricular pseudoaneurysm may be repaired with a left thoracotomy totally endoscopic approach.

Left ventricular pseudoaneurysm of the inferior wall with thrombus: diagnosis and management

Left ventricular pseudoaneurysm of the inferior wall with thrombus: diagnosis and management

Incidentally Detected Chronic Left Ventricular Pseudoaneurysm After Subacute Inferior–Posterior Myocardial Infarction

We describe a 69-year-old man with subacute inferior myocardial infarction who had surgical repair for a left ventricular (LV) pseudoaneurysm incidentally detected by routine 6-month follow-up echocardiography. Although LV pseudoaneurysm is a rare complication after myocardial infarction, the delayed diagnosis and management can cause adverse patient outcomes. The present case suggests that patients with multiple risk factors for LV pseudoaneurysms, including advanced age, late presentation, and delayed revascularization, should receive intensive blood pressure control and closer examination using a multimodal imaging approach for early detection of aneurysmal formation and complications.

Large Left Ventricular Pseudoaneurysm Presenting as an Embolic Stroke After a "Silent" Myocardial Infarction.

A 72-year-old woman with no history of coronary artery disease presented with an acute left middle cerebral artery stroke and was found to have a large left ventricular pseudoaneurysm measuring 8.7 × 7.6 cm and 2 large left ventricular thrombi, the source of her systemic embolization. Despite initial medical management, she developed refractory New York Heart Association functional class III heart failure, uncontrolled atrial fibrillation, and further enlargement of her pseudoaneurysm to 5.5 × 10.6 × 9.2 cm. She underwent urgent aneurysmectomy. Left ventricular pseudoaneurysms are rare and most commonly occur following an acute myocardial infarction when a ventricular free-wall rupture is contained by pericardium or thrombi. Historically, left ventricular angiography displaying a lack of an overlying coronary artery was the gold standard for diagnosis. Now, noninvasive imaging such as computed tomography, magnetic resonance imaging, and echocardiogram with ultrasound-enhancing agent, are reliable diagnostic tools. They can distinguish a pseudoaneurysm from a true left ventricular aneurysm using characteristic findings such as a narrow aneurysm neck, bidirectional doppler flow between the pseudoaneurysm and the left ventricle, and abrupt changes in the cardiac wall structures. Progressive dilation, wall thinning, and dyskinesis can result in refractory heart failure, arrhythmias, and thrombi formation from venous stasis. Pseudoaneurysms have a 30% to 45% risk of rupture and can be treated with left ventricular aneurysmectomy.

Iatrogenic Left Ventricular Pseudoaneurysm After Successful Radiofrequency Catheter Ablation for Premature Ventricular Contraction Originating From the Posterior Papillary Muscles.

Iatrogenic Left Ventricular Pseudoaneurysm After Successful Radiofrequency Catheter Ablation for Premature Ventricular Contraction Originating From the Posterior Papillary Muscles.

Left Ventricular Outflow Tract Pseudoaneurysm Compresses Left Anterior Descending Artery: A Case Report and Review of Literature

A case of a 49-year-old man with a history of buprenorphine-substituted heroin was admitted for acute heart failure after three months of bioprosthetic aortic replacement to treat infective endocarditis. Transthoracic echocardiography (TTE) showed a left ventricular ejection fraction (EF) was 35% and a periprosthetic mass with an aorto-ventricular fistula. Thoracic computed tomography revealed a left ventricular outflow tract (LVOT) pseudoaneurysm measuring 69 x 45 mm that compressed left anterior descending (LAD) artery with downstream myocardial ischemia. Patient was treated by an urgent surgery, including an exclusion of the pseudoaneurysm, a left ventricular reconstruction surgery and a bioprosthetic aortic replacement. Patient went through a difficult postoperative period. Finally, he was safely discharged with a low EF (34%) from hospital to rehabilitation center with a Life vest. This case spotlights a rare devastating complication of a LVOT pseudoaneurysm compresses LAD artery and how surgery could decompress the false aneurysm and stabilize ischemia.

Pseudoaneurysm of the left ventricular free wall occurring after cardiac surgery of endocarditis affecting mitral and aortic valves: a case report

BackgroundInfective endocarditis remains a serious condition. Left ventricular pseudoaneurysm may complicate the clinical course of infective endocarditis or occur postoperatively.Case presentationWe describe a case of a pseudoaneurysm of the left ventricular lateral wall which developed one month following cardiac surgery of active endocarditis affecting aortic and mitral valves. The diagnosis was established by transthoracic echocardiography and computed tomography angiography of the chest. Urgent cardiac surgery is performed with excision of the pseudoaneurysm and direct closure of the defect. The patient had a complete recovery and was discharged on the twelfth postoperative day.ConclusionsLeft ventricular pseudoaneurysms are rare but potentially fatal. The symptoms revealing such complications are very diverse. Surgical treatment can be offered to younger patients.

Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation

HomeCirculation: Cardiovascular ImagingVol. 16, No. 1Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation No AccessResearch ArticleRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessResearch ArticleRequest AccessFull TextMycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation Kevin Shahbahrami, MD, Candice Y. Lee, MD and Masaki Tsukashita, MD, PhD Kevin ShahbahramiKevin Shahbahrami Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author , Candice Y. LeeCandice Y. Lee Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author and Masaki TsukashitaMasaki Tsukashita Correspondence to: Masaki Tsukashita, MD, PhD, Department of Cardiothoracic Surgery, Allegheny General Hospital, 320 East North Ave, South Tower 14th Floor, Pittsburgh, PA 15212. Email E-mail Address: [email protected] https://orcid.org/0000-0001-9387-4759 Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA. Search for more papers by this author Originally published17 Jan 2023https://doi.org/10.1161/CIRCIMAGING.122.014278Circulation: Cardiovascular Imaging. 2023;16"Mycotic Left Ventricular Apical Pseudoaneurysm Following HM3 Left Ventricular Assist Device Implantation." Circulation: Cardiovascular Imaging, 16(1), pp. e014278–FootnotesFor Sources of Funding and Disclosures, see page 110.Correspondence to: Masaki Tsukashita, MD, PhD, Department of Cardiothoracic Surgery, Allegheny General Hospital, 320 East North Ave, South Tower 14th Floor, Pittsburgh, PA 15212. Email masaki.[email protected]org

Incidental Imminent Rupture of the Left Ventricular Pseudo-aneurysm.

Incidental Imminent Rupture of the Left Ventricular Pseudo-aneurysm.

78 FOUR YEARS ECHOCARDIOGRAPHIC FOLLOW-UP OF A LEFT VENTRICULAR PSEUDOANEURYSM

Abstract Introduction Left ventricular pseudoaneurysm is a rare and often fatal complication of myocardial infarction. It has an incidence of 0,2-0,4% of all the STEMI and a very high mortality, particularly in the first month. Symptoms can vary from shortness of breath on exertion, orthopnea, chest pain, fatigue. At least 10% of patients do not present any symptoms and the pseudoaneurysm is diagnosed incidentally during a follow-up appointment. Signs include persistent ST elevation on EKG and its diagnosis can easily be made with a transthoracic echocardiogram and more in depth with a CT scan and a cardiac MRI. Its treatment is surgical, but the choice is up to the anesthesiologist and cardiothoracic surgeon, depending on patient's comorbidity and surgery risk. Surgical treatment has a high rate of death, reaching even the 37%. Background We present the case of a 74 years old patient with an history of chronic hypertension and cerebral vasculopathy, who sustained a STEMI in 2017. Urgent coronarography study was performed, but unfortunately the angioplasty treatment was unsuccessful and the left anterior descending artery could not be recanalized. Therefore, the patient was transferred to the cardiothoracic department in order to undergo bypass surgery: surgery was performed five days after, using left internal mammary artery to the left anterior descending artery and great saphenous vein to the first diagonal. Surgery went well with no complications; the post-operative period passed by without any complications and, after 15 days, patient was discharged with no complains. Two months later, he was admitted to intensive care unit of a hospital of our town, because of dyspnea (NYHA 3), peripheral edema, moderate-severe mitral insufficiency, moderate pleural and pericardial effusion. He underwent a CT-scan that showed “9×6,4 cm cavity with blood that seemed to have a connection with the postero-lateral wall of the left ventricle”. He also underwent a cardiac MRI that displayed a pseudoaneurysm with an endoluminal thrombus. After an accurate evaluation of the case, the Heart Team decided to do not perform surgery because of the high risk of the patient. Thence, we have been followed him with close echocardiographic exams for more than four years. Methods From March 2018 to September 2022, we have been followed the patient with complete echocardiographic follow-ups, done every three-six month. Results and conclusions Patient with left ventricle pseudoaneurysm due to an extensive myocardial infarction has been followed in our echo lab for more than 4 years. He has been stable during these years, NYHA II, in a good clinical and hemodynamical state.