Surgical reconstruction of coexisting left ventricular aneurysm and pseudoaneurysm in a patient with ventricular tachycardia: a case report

TL;DR

A 69-year-old woman with a rare combination of left ventricular aneurysm and pseudoaneurysm underwent successful surgical repair, improving heart function and reducing arrhythmia risk.

Contribution

The case highlights surgical strategies for complex coexisting LV aneurysm and pseudoaneurysm, offering insights into optimal timing and technique.

Findings

Surgical reconstruction with a Dacron patch effectively restored LV geometry and function.

Postoperative sinus rhythm was preserved with no arrhythmic events.

Comprehensive imaging is crucial for diagnosing complex post-infarction LV remodeling.

Abstract

Left ventricular (LV) aneurysm and pseudoaneurysm are rare but potentially life-threatening complications of myocardial infarction. Their coexistence poses significant diagnostic and surgical challenges.

A 69-year-old woman with type II diabetes, hypertension, and dyslipidaemia presented with sustained ventricular tachycardia while remaining haemodynamically stable. Multimodality imaging revealed a chronic myocardial infarction with complete right coronary artery occlusion, a large LV aneurysm, and a focal pseudoaneurysm. Urgent LV reconstruction using a Dacron patch was performed. The postoperative course was uneventful, with preserved sinus rhythm and improved ventricular function.

This case underscores the importance of comprehensive imaging to characterize complex post-infarction LV remodelling. Surgical exclusion of scarred myocardium effectively restored LV geometry, improved cardiac function, and reduced arrhythmic risk. The successful repair provides insight into the decision-making process regarding optimal timing and technique for LV reconstruction.

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