ACA App
Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
Home | About us | Editorial Board | Search | Ahead of print | Current Issue | Archives | Submission | Subscribe | Advertise | Contact | Login 
Users online: 576 Small font size Default font size Increase font size Print this article Email this article Bookmark this page
 


 

 
     
    Advanced search
 

 
 
     
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
    References
    Article Figures

 Article Access Statistics
    Viewed909    
    Printed19    
    Emailed0    
    PDF Downloaded82    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents
BRIEF COMMUNICATION  
Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 571-572
Large left ventricular pseudoaneurysm and spontaneous recanalized coronaries


Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India

Click here for correspondence address and email

Date of Submission16-Feb-2015
Date of Acceptance06-Jul-2015
Date of Web Publication1-Oct-2015
 

   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 2021 Apr 22];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 1: Mid esophageal four chamber view showing pseudoaneurysm

Click here to view
Figure 2: Opened pseudoaneurysmal cavity and the defect in left ventricle lateral wall

Click here to view


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. J Am Coll Cardiol 1998;32:557-61.  Back to cited text no. 1
    
2.
Prêtre R, Linka A, Jenni R, Turina MI. Surgical treatment of acquired left ventricular pseudoaneurysms. Ann Thorac Surg 2000;70:553-7.  Back to cited text no. 2
    
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.  Back to cited text no. 3
    
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.  Back to cited text no. 4
    

Top
Correspondence Address:
Ramesh Varadharajan
Department of Anaesthesiology and Critical Care, JIPMER, Puducherry
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.166467

Rights and Permissions


    Figures

  [Figure 1], [Figure 2]



 

Top