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Praveen Varma
Amit Korach
Oz M. Shapira
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J Thorac Cardiovasc Surg 2008;135:1382-1383
© 2008 The American Association for Thoracic Surgery

Brief Communication

Transmitral endocavitary repair of inferior left ventricular pseudoaneurysm: A simplified approach in patients requiring concomitant mitral valve surgery

Pranava Sinha, MD, Praveen Varma, MD, Amit Korach, MD, Oz M. Shapira, MD*

Department of Cardiothoracic Surgery, Boston Medical Center, Boston, Mass

Received for publication October 16, 2007; accepted for publication December 12, 2007.

* Address for reprints: Oz M. Shapira, MD, Department of Cardiothoracic Surgery, Hadassah Medical Center PO Box 12000, Ein Kerem Jerusalem, 91120 Isreal Tel (+972) 2 677 6960 / 1 Fax (972) 2 643 8005. (Email: ozshapira@Hadassah.org.il).

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

Left ventricular pseudoaneurysms (LVPAs) arise from contained myocardial rupture after acute myocardial infarction. Their propensity to rapid enlargement and rupture mandates expeditious surgical management.1Go We report a case of LVPA repair through an endocavitary transmitral approach in a patient undergoing concomitant mitral valve surgery.

Clinical Summary

An 82-year-old man with a history of two myocardial infarctions and ischemic cardiomyopathy was seen with congestive heart failure and angina. Transthoracic echocardiography demonstrated dilated left ventricle, left ventricular ejection fraction of 30%, a large inferior LVPA (Go Figure 1, A), and severe ischemic mitral regurgitation. Cardiac magnetic resonance imaging confirmed the presence of a 63 x 58 x 41-mm inferior LVPA adjacent to the mitral valve (Figure 1, B). Coronary angiography showed severe three-vessel disease.


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