Left Ventricular Giant Pseudoaneurysm

2010 ◽  
Vol 5 (4) ◽  
pp. 303-305
Author(s):  
Uğur Filizcan ◽  
Sebnem Cetemen ◽  
Ozer Soylu ◽  
Mehmet Bicer ◽  
Hakki Aydogan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chest Trauma ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Scar Tissue ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Bacterial Endocarditis ◽  
Valve Surgery ◽  
Giant Pseudoaneurysm

Left ventricular (LV) pseudoaneurysm is a rare complication of myocardial infarction. It may also occur as a complication of mitral valve surgery, chest trauma, and bacterial endocarditis. It forms when a cardiac rupture contains adherent pericardium or scar tissue and is typically located on the posterior or inferior LV wall. Pseudoaneurysms have a propensity to spontaneous rupture; hence, immediate surgical intervention is the treatment of choice for LV pseudoaneurysms diagnosed in the first months after myocardial infarction. The management of chronic LV pseudoaneurysms is still a subject of debate.

scholarly journals Late atrioventricular groove disruption presenting 7 years after mitral valve replacement: a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Ciro Mancilha Murad ◽  
Letícia Braga Ferreira ◽  
Rochelle Coppo Militão Rausch ◽  
Cláudio Léo Gelape
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Scar Tissue ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Mechanical Prosthesis ◽  
Atrioventricular Groove

Abstract Background Left ventricular rupture is the most feared complication in mitral valve surgery. Despite its low incidence, mortality rates can reach up to 75%. It usually presents on the operating room with a dissecting haematoma followed by massive bleeding after discontinuing cardiopulmomary bypass. However, cardiac rupture may be contained by adherent pericardium or scar tissue leading to chronic formation of a pseudoaneurysm (PSA). Case summary A 44-year-old man came to our institution with acute heart failure triggered by community-acquired pneumonia. He underwent mitral valve replacement with a mechanical prosthesis 7 years before and reported suffering from chronic worsening dyspnoea for 18 months. He underwent chest computed tomography scan and cardiac magnetic resonance imaging (CMRI), which showed two extensive left ventricular (LV) multilobulated PSAs. An operative approach was chosen and a tear was found on the posterior atrioventricular groove (AVG), communicating left ventricle with the PSA, which was closed with bovine pericardium patch. After weaning from cardiopulmonary bypass, he presented a diffuse life-threatening bleeding. The surgeons packed his chest with compresses before closing the sternum and he was operatively revised after 48 h. Post-operative CMRI showed that one of the PSAs remained connected with the LV. Despite of all, 1 year after hospital discharge, he remains asymptomatic without signs of heart failure. Discussion This case illustrates PSAs' potential to grow for a long period before causing symptoms, the complexity and risks of chronic AVG disruption surgery and the importance of careful annular manipulation and debridement as preventive measures in mitral valve surgery.

scholarly journals Effect of cardiosphere-derived cells on segmental myocardial function after myocardial infarction: ALLSTAR randomised clinical trial

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001614
Author(s):  
Mohammad R Ostovaneh ◽  
Raj R Makkar ◽  
Bharath Ambale-Venkatesh ◽  
Deborah Ascheim ◽  
Tarun Chakravarty ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Trial ◽  
Myocardial Function ◽  
Randomised Clinical Trial ◽  
Scar Tissue ◽  
Left Ventricular ◽  
Lv Function ◽  
Cardiac Events ◽  
Lv Dysfunction ◽  
Registration Number

BackgroundMost cell therapy trials failed to show an improvement in global left ventricular (LV) function measures after myocardial infarction (MI). Myocardial segments are heterogeneously impacted by MI. Global LV function indices are not able to detect the small treatment effects on segmental myocardial function which may have prognostic implications for cardiac events. We aimed to test the efficacy of allogeneic cardiosphere-derived cells (CDCs) for improving regional myocardial function and contractility.MethodsIn this exploratory analysis of a randomised clinical trial, 142 patients with post-MI with LVEF <45% and 15% or greater LV scar size were randomised in 2:1 ratio to receive intracoronary infusion of allogenic CDCs or placebo, respectively. Change in segmental myocardial circumferential strain (Ecc) by MRI from baseline to 6 months was compared between CDCs and placebo groups.ResultsIn total, 124 patients completed the 6-month follow-up (mean (SD) age 54.3 (10.8) and 108 (87.1%) men). Segmental Ecc improvement was significantly greater in patients receiving CDC (−0.5% (4.0)) compared with placebo (0.2% (3.7), p=0.05). The greatest benefit for improvement in segmental Ecc was observed in segments containing scar tissue (change in segmental Ecc of −0.7% (3.5) in patients receiving CDC vs 0.04% (3.7) in the placebo group, p=0.04).ConclusionsIn patients with post-MI LV dysfunction, CDC administration resulted in improved segmental myocardial function. Our findings highlight the importance of segmental myocardial function indices as an endpoint in future clinical trials of patients with post-MI.Trial registration numberNCT01458405.

scholarly journals Takotsubo syndrome after mitral valve surgery: a case report

2020 ◽  
Author(s):  
Ana Devesa ◽  
Rafael Hernández-Estefanía ◽  
José Tuñón ◽  
Álvaro Aceña
Keyword(s):  
Mitral Valve ◽  
Fatal Outcome ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Lv Function ◽  
Partial Recovery ◽  
Takotsubo Syndrome ◽  
Left Circumflex Artery ◽  
Coronary Syndrome

Abstract Background Takotsubo syndrome is a frequent entity; however, it has never been described after a mitral valve surgery. Case summary  We present the case of a 79-year-old woman, with background of atrial fibrillation and a left atrial appendage closure device, who was admitted for elective mitral valve replacement, because of asymptomatic severe primary mitral regurgitation. Biologic mitral valve was implanted without incidences, but in the postoperative, she developed cardiogenic shock. Electrocardiogram (ECG) showed inverted T waves in precordial leads and an echocardiography showed severe left ventricular (LV) dysfunction with mid to distal diffuse hypokinesis, and better contractility in basal segments. Troponin levels were mildly elevated. With the suspicion of a postoperative acute coronary syndrome, a coronary angiography was performed and showed no significant coronary lesions. The haemodynamic situation was compromised for the next 48 h, in which vasoactive support and intra-aortic balloon counterpulsation were implemented. After 48 h, the haemodynamic situation suddenly improved. The ECG was normalized, and a control echocardiogram showed partial recovery of the LV function with resolution of regional wall motion abnormalities. The patient could be discharged at 1 week. The clinical picture was interpreted as a stress cardiomyopathy after mitral valve surgery. Discussion  Takotsubo syndrome is a threatening condition; complications in acute phase could lead to a fatal outcome. Mitral valve surgery has to be considered as a trigger for this entity, after excluding coronary involvement, specially of left circumflex artery.

Doppler-derived left ventricular rate of pressure rise and inotropic requirements during mitral valve surgery

1998 ◽  
Vol 12 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Serge M. Broka ◽  
Anne R. Ducart ◽  
Jacques Jamart ◽  
Edith L. Collard ◽  
Xavier R. Fournet ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pressure Rise ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Ventricular Rate

scholarly journals Successful Surgical Treatment of Postinfarction Rupture of Left Ventricular Myocardium

2020 ◽  
Vol 9 (1) ◽  
pp. 140-147
Author(s):  
M. K. Mazanov ◽  
N. I. Kharitonova ◽  
A. A. Baranov ◽  
S. Yu. Kambarov ◽  
N. M. Bikbova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Surgical Intervention ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Free Wall ◽  
Fatal Complication ◽  
Widespread Availability ◽  
Complications Of Myocardial Infarction

ABSTRACT. The rupture of the left ventricle free wall is one of the most dangerous complications of myocardial infarction. Due to the widespread availability of echocardiography method, the detection of this fatal complication and the number of lives saved after surgery grew. The survival of patients depends on early diagnosis, stabilization of the patient’s condition, promptness and tactics of surgical intervention. We report a case of successful closure of a rupture of the left ventricle free wall on the 15th day after myocardial infarction.

scholarly journals The clinical significance of left ventricular sphericity in patients undergoing mitral valve surgery

1998 ◽  
Vol 31 ◽  
pp. 284
Author(s):  
J.J. Gomez ◽  
D.J.S. Schor ◽  
E.A. Traad ◽  
R.G. Carrillo ◽  
D.B. Williams ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Clinical Significance ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery
Sign in / Sign up

Export Citation Format

Share Document