Postinfarction left ventricular pseudoaneurysm

Kalman Csapo, Laszlo Voith, Tibor Szuk, Istvan Edes, Dean J. Kereiakes

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42 Citations (Scopus)

Abstract

Left ventricular wall rupture after myocardial infarction is a mechanical complication that may result in a pseudoaneurysm. Between January 1994 and October 1996, false or pseudoaneurysms were detected in 6 (0.0026%) of 2,600 consecutive patients (4 women, 2 men; mean age 59.4 years) undergoing cardiac catheterization at University Medical School, Debrecen, Hungary. All patients had a history of cardiovascular disease, with diagnosis of pseudoaneurysm confirmed by echocardiography. The average time from the occurrence of acute infarction to diagnosis was 37.0 days (range 3-80 days). All patients were in New York Heart Association functional class IV congestive heart failure; in four patients cardiogenic shock was present. Five patients underwent coronary angiography, which demonstrated multivessel disease and occlusion of the infarct-related artery (TIMI 0) with-out adequate collateral circulation (grade 0-1). Five patients had surgical repair of the false aneurysm, and, in three patients, concomitant coronary bypass grafting was performed. The 2-year mortality rate for all patients was 50%. Early diagnosis of false aneurysm is facilitated by echocardiography, and coronary angiography is required before surgery. Early surgical correction with coronary revascularization is advised.

Original languageEnglish
Pages (from-to)898-903
Number of pages6
JournalClinical Cardiology
Volume20
Issue number10
DOIs
Publication statusPublished - Oct 1997

Keywords

  • Myocardial infarction
  • Myocardial rapture
  • Pseudoaneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Csapo, K., Voith, L., Szuk, T., Edes, I., & Kereiakes, D. J. (1997). Postinfarction left ventricular pseudoaneurysm. Clinical Cardiology, 20(10), 898-903. https://doi.org/10.1002/clc.4960201021