ABSTRACT
Four patients are presented in whom either a false aneurysm or a "pseudo-false" aneurysm of the left ventricle developed following a myocardial infarction. False aneurysms of the left ventricle are unusual and are distinctly different from the more common true aneurysms. A false aneurysm is the result of a contained hematoma dissecting, into a transmural infarct. It communicates with the left ventricle through a small orifice. Previous descriptions of false aneurysms have stressed that their wall consists of pericardium and mural thrombus and lack identifiable epicardial or myocardial elements. Two pseudo-false aneurysms are described. They communicated with the left ventricle through a small orifice but their wall contained myocardial tissue. False aneurysms have a tendency to rupture and therefore their presence alone is an indication for operation. One of the pseudo-false aneurysms discussed ruptured into the right ventricle. The operation for false aneurysm may be simpler than that for true aneurysm since it might be possible to close the small communication into the left ventricle without resecting the entire aneurysm wall.
Subject(s)
Heart Aneurysm/diagnosis , Adult , Diagnosis, Differential , Female , Heart Aneurysm/etiology , Heart Aneurysm/pathology , Heart Aneurysm/surgery , Heart Ventricles , Hematoma/diagnosis , Humans , Male , Middle Aged , Myocardial Infarction/complicationsABSTRACT
A 28-year-old woman underwent cardiac catheterization three months after sustaining an acute anterolateral myocardial infarct. An aneurysm of the left main coronary artery was found at angiography and also was visualized by two-dimensional echocardiography. The patient had no evidence of atherosclerotic vascular disease. At operation, vein grafts were placed to bypass the aneurysm and the orifice of the left coronary artery was oversewn to exclude the aneurysm from the coronary circulation.
