Left ventricular pseudo-false aneurysm perforating into the right ventricle.

ABSTRACT

Left ventricular pseudo-false aneurysms are a very rare complication of myocardial infarction. Occasionally, they will perforate into the right ventricle. Their haemodynamic presentation is similar to postinfarction ventricular septal defect. Even with no early clinical symptoms, they can lead to congestive heart failure or sudden fatal rupture. We report on a 67-year old man who developed a large left ventricular pseudo-false aneurysm that perforated into the right ventricle late after acute inferior myocardial infarction. He had undergone percutaneous coronary intervention to the right coronary artery in August 2013. During the surgery performed in July 2014, with only incision at the aneurysm, the small perforation to the right ventricle was closed directly and the large perforation to the left ventricle was closed with a bovine pericardial patch. Considering the late mechanical complications attendant to left ventricular remodelling, physicians should conduct careful long-term follow-up of patients with transmural myocardial infarction, even if previous percutaneous coronary intervention was successfully performed.