Abstract
4/2008
vol. 5
DZIELIMY SIĘ DOŚWIADCZENIEM
Large true left ventricular aneurysm
Kardiochirurgia i Torakochirurgia Polska 2008; 5 (4): 436–439
Online publish date: 2008/12/30
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.
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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