eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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4/2008
vol. 5
 
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abstract:

DZIELIMY SIĘ DOŚWIADCZENIEM
Large true left ventricular aneurysm

Paweł Bugajski
,
Radosław Jarząbek
,
Krzysztof Greberski
,
Roman Olszewski
,
Ireneusz Jedliński
,
Małgorzata Duszyńska
,
Tomasz Wardęga
,
Ryszard Kalawski

Kardiochirurgia i Torakochirurgia Polska 2008; 5 (4): 436–439
Online publish date: 2008/12/30
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Background: Left ventricular aneurysm results most commonly from myocardial infarction. True or false – in many cases is apparent only when surgery is done.

Case report: A 61-year-old male was admitted to the hospital due to weakness, exercise tolerance deterioration and increasing dyspnoea. He did not complain of chest pain. TEE examination revealed a false left ventricular aneurysm of the posterior wall containing thrombotic material. Coronarography showed total occlusion of CX and non-critical occlusion of LAD. Aneurysmectomy revealed a huge, true left ventricular aneurysm of the posterior wall, attached to the diaphragm and relocating the heart. Dislocation of heart made ascending aorta cannulation impossible; thus femoral cannulation was performed. The left ventricle was closed by a double layer linear suture and two venous coronary-artery grafts were sewn.

Results: The postoperative course was complicated by transient symptoms of confusion and pneumonia. On POD 14 the patient in good overall condition was discharged from the cardiac surgery department.

Conclusions: The symptoms of left ventricular aneurysm could be the first symptoms of myocardial infarction. Eventually the surgical procedure revealed a true left ventricular aneurysm that was depicted as a false aneurysm in preoperative evaluation. Uncommon arterial cannulation could improve safety of the surgical procedure.
keywords:

true aneurysm, aneurysmectomy

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