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J Thorac Cardiovasc Surg 2004;128:765-767
© 2004 The American Association for Thoracic Surgery

Brief communication

Surgical repair of a leaking double postinfarction left ventricular pseudoaneurysm

Predrag Milojevic, MD, FETCSa,*, Vojislava Neskovic, MD, DEAAa, Milan Vukovic, MDa, Dusko Nezic, MD, PhD, FETCSa, Bosko Djukanovic, MD, PhDa

a Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia and Montenegro, Yugoslavia

Received for publication March 8, 2004; revisions received March 29, 2004; accepted for publication April 6, 2004.

* Address for reprints: Predrag Milojevic, MD, FETCS, Department of Cardiac Surgery II, Dedinje Cardiovascular Institute, M. Tepica 1, 11040 Belgrade, Serbia and Montenegro, Yugoslavia
pmilojevic@sezampro.yu

The first 20% of the full text of this article appears below.

Left ventricular pseudoaneurysm is an uncommon complication of transmural myocardial infarction. It usually forms several weeks after the infarction on the inferior or posterolateral left ventricular wall when cardiac rupture is contained by the adherent pericardium.


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  		Figure 1. Transesophageal echocardiography: modified longitudinal 2-chamber view. Discontinuity of the inferoposterior myocardial wall at 2 separate places (arrows).. with 2 narrow-neck aneurysmal sacs, indicating pseudoaneurysm formation is shown. LV,..Left ventricle; PE,..pericardial effusion.

 
Pseudoaneurysm is characterized by a narrow neck in comparison with the diameter of the pseudoaneurysmal sac. Through this sharp discontinuity of myocardial tissue, the pseudoaneurysm communicates with the left ventricular chamber, and bidirectional blood flow can be registered by means of color Doppler echocardiography during the cardiac circle. Considering the risk of secondary rupture or leaking, different treatments are recommended.

We present a case of double inferoposterior left ventricular pseudoaneurysm. To our knowledge, this is the first reported case of double pseudoaneurysm successfully surgically repaired.

Clinical summary

A 45-year-old . . . [Full Text of this Article]






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