J Cardiovasc Imaging.  2018 Dec;26(4):250-252. 10.4250/jcvi.2018.26.e24.

Asymptomatic Multiple Lobulated Giant Left Ventricular Pseudoaneurysms Following Double Valve Replacement

• Kazmi DH
• Khanna R
• Soni N
• Kapoor A

• KMID: 2430001
• DOI: http://doi.org/10.4250/jcvi.2018.26.e24

Abstract

No abstract available.

MeSH Terms

Aneurysm, False*

Figure

• 

  Figure 1 Transthoracic echocardiography. (A) Apical 4 chamber view with tilt revealed a PSA arising from LV and compressing RA and RV anteriorly and (B) the anatomy was better delineated using 3D imaging. (C, D) Modified parasternal short axis view localizes the origin of the aneurysm from the base of LV through a narrow neck along with delineation of its size and inferior extensions. LV: left ventricle, PSA: pseudoaneurysm, RA: right atrium, RV: right ventricle.

• 

  Figure 2 CT angiogram. (A) A large lobulated pseudoaneurysm (PSA) with narrow neck (red arrow) is seen arising from the base of the left ventricle wall, near the posterior atrioventricular groove. (B) This is further extending along the posterior atrioventricular groove and indenting on the dome of diaphragm anteriorly. (C) Volume rendered image is clearly depicting the neck (blue arrow) of aneurysm. Axial oblique coronary CT angiogram (D) and volume rendered image (E) show another small lobulated PSA with narrow neck (orange arrow), arising from the lateral wall of the left ventricle, near mitral valve. Coronal oblique coronary CT angiogram (B) and volume rendered image (F) show the third small lobulated PSA (green arrows in B and F), juxta aortic annulus.

Reference

1. Roberts WC, Morrow AG. Causes of early postoperative death following cardiac valve replacement. Clinico-pathologic correlations in 64 patients studied at necropsy. J Thorac Cardiovasc Surg. 1967; 54:422–437.

2. Waller BF, Taliercio CP, Clark M, Pless JE. Rupture of the left ventricular free wall following mitral valve replacement for mitral stenosis: a cause of complete (fatal) or contained (false aneurysm) cardiac rupture. Clin Cardiol. 1991; 14:341–345.

3. Frances C, Romero A, Grady D. Left ventricular pseudoaneurysm. J Am Coll Cardiol. 1998; 32:557–561.

4. Hulten EA, Blankstein R. Pseudoaneurysms of the heart. Circulation. 2012; 125:1920–1925.