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| Year : 2015
| Volume
: 18 | Issue : 4 | Page
: 571-572 |
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| Large left ventricular pseudoaneurysm and spontaneous recanalized coronaries |
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Ramesh Varadharajan, Satyen Parida, Ashok Badhe
Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India
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email
| Date of Submission | 16-Feb-2015 |
| Date of Acceptance | 06-Jul-2015 |
| Date of Web Publication | 1-Oct-2015 |
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 Abstract | | |
35 year old with ruptured lateral wall of Left ventricle (LV) resulting in large pseudo aneurysm contained within the pericardium [Figure 1]. There was free flow of blood between the LV and pseudoaneurysm .He underwent endoventricular patch plasty of the defect after opening the wall of aneurysm [Figure 2]. Keywords: LV Pseudoaneurysm; Recanalised coronary; Transesophageal echo
How to cite this article:
Varadharajan R, Parida S, Badhe A. Large left ventricular pseudoaneurysm and spontaneous recanalized coronaries. Ann Card Anaesth 2015;18:571-2 |
How to cite this URL:
Varadharajan R, Parida S, Badhe A. Large left ventricular pseudoaneurysm and spontaneous recanalized coronaries. Ann Card Anaesth [serial online] 2015 [cited 2022 Jan 28];18:571-2. Available from: https://www.annals.in/text.asp?2015/18/4/571/166467 |
A 35-year-old man had come to the cardiovascular outpatient department with vague chest discomfort and shortness of breath for 3 months duration. He had a history of severe, sudden onset chest pain 4 months back which settled with sublingual nitrates from a local pharmacy. His history was negative for trauma, previous cardiac surgery/ablation and chronic cardiac ailments. 12-lead ECG showed ST elevation in lateral leads and T-wave inversion in inferior leads. His two-dimensional echo findings were shocking to us. He had a ruptured lateral wall of a left ventricle (LV) resulting in a large pesudoaneurysm. [1] contained within the pericardium [Figure 1]. The neck of the pseudoaneurysm measured around 35 mm and the largest diameter of the aneurysmal cavity measured around 125 mm. Retrospective auscultation of the heart revealed a grade 4/6 holosystolic murmur. There was a free flow of blood between the LV and pseudoaneurysm during the phases of the cardiac cycle. His coronary angiogram was surprisingly normal. He underwent an endoventricular patch plasty. [2],[3] of the defect [Figure 2]. He could be weaned from bypass after the institution of intra-aortic balloon pump along with high inotropic support. Myocardial infarction as a result of coronary artery disease is the most common cause of LV pseudoaneurysm. However, our patient had a recanalized normal coronary with LV pseudoaneurysm. Though we did not do an endomyocardial biopsy to rule out other causes, thrombotic occlusion and subsequent spontaneous recanalization of left circumflex artery was felt to be the primary cause of this pseudoaneurysm. [4] | Figure 2: Opened pseudoaneurysmal cavity and the defect in left ventricle lateral wall
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Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. J Am Coll Cardiol 1998;32:557-61.  |
| 2. | Prêtre R, Linka A, Jenni R, Turina MI. Surgical treatment of acquired left ventricular pseudoaneurysms. Ann Thorac Surg 2000;70:553-7. |
| 3. | Eren E, Bozbuga N, Toker ME, Keles C, Rabus MB, Yildirim O, et al. Surgical treatment of post-infarction left ventricular pseudoaneurysm: A two-decade experience. Tex Heart Inst J 2007;34:47-51. |
| 4. | Cho JM, Raffel OC, Stone JR, Kim CJ, Jang IK. Spontaneous recanalization of a coronary artery after thrombotic occlusion: In vivo demonstration with optical coherence tomography. J Am Coll Cardiol 2010;55:1274. |
Correspondence Address:
Ramesh Varadharajan
Department of Anaesthesiology and Critical Care, JIPMER, Puducherry
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-9784.166467
[Figure 1], [Figure 2] |
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