Abstract
A 59-year-old male patient underwent surgery for triple-vessel coronary artery disease and left-ventricular aneurysm in 1994. Four months after coronary artery bypass grafting and classical left-ventricular aneurysmectomy (with Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyde-treated pericardium patch over which an omental pedicle graft was placed. Two months later, under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later. Sternocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months after the last surgical intervention, the patient died of cerebral malignancy. Pseudoaneurysm reformation, however, had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative techniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscle flaps be strongly considered as a material for re-repair of left-ventricular aneurysms.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bluett M., Bolling S. F., Kirsh M. M. Management of recurrent ventricular pseudoaneurysm. Tex Heart Inst J. 1991;18(1):69–71. [PMC free article] [PubMed] [Google Scholar]
- Gaos C. M., Fighali S., Coronado R., Hernandez G., Quintanilla M., Cooley D. A. Recurrent left ventricular pseudoaneurysm: diagnosed by color-flow Doppler echocardiography. Tex Heart Inst J. 1990;17(3):190–191. [PMC free article] [PubMed] [Google Scholar]
- Mackenzie J. W., Lemole G. M. Pseudoaneurysm of the left ventricle. Tex Heart Inst J. 1994;21(4):296–301. [PMC free article] [PubMed] [Google Scholar]
- Milgalter E., Uretzky G., Levy P., Appelbaum A., Borman J. B. Pseudoaneurysm of the left ventricle. Thorac Cardiovasc Surg. 1987 Feb;35(1):20–25. doi: 10.1055/s-2007-1020191. [DOI] [PubMed] [Google Scholar]