Cardiac ventricular aneurysm

Abstract

A case of successful excision of a ventricular aneurysm due to myocardial infarction is presented. The aetiology, incidence, pathogenesis, pathology, clinical features, and diagnosis of the condition are discussed. An account is given of the haemodynamic upset caused by aneurysms of the ventricle. The prognosis of untreated aneurysms is discussed. Although there is difference of opinion, it is concluded that a ventricular aneurysm adversely affects the prognosis after myocardial infarction. The indications for, and the mortality and results of, resection of ventricular aneurysms are discussed. The conclusion is drawn that persistent cardiac failure and angina can be relieved and the risk of systemic embolism reduced by the excision of expansile ventricular aneurysms of a fibrous nature. It is possible that excision may also reduce the incidence of subsequent acute myocardial infarction.

Elective operations for post-infarction left ventricular aneurysms.

“…In our series, the earliest diagnosis was made 23 days after causative myocardial infarction. Predisposing factors, such as hypertension which increases the transmural tension exerted against the functionless portion of the ventricular wall, reported by others, were not conclusive in our series (Schlichter et al, 1954;Harley, 1969;Davis and Ebert, 1972). Aneurysm formation is more commonly seen in males, and although younger people are not exempt, most occur in the 60-70 year age group.…”

“…Although posterior myocardial infarctions are common, development of a posterior ventricular aneurysm is not. This is possibly explained by the fact that such infarcts can involve the posterior papillary muscle and the resulting severe mitral regurgitation superimposed on the acute myocardial infarction precipitates fatal left ventricular failure (Abrams et al, 1963;Favaloro et al, 1968;Harley, 1969;Ibarra-Perez and Lillehei, 1969;Schattenberg et al, 1970;Loop et al, 1973). In our series, both posterior aneurysms (and the superior aneurysm) were associated with mitral regurgitation (two) or ventricular septal defect (one).…”

False Aneurysm of a Left Ventricular Stab Wound for Left Vent during Extracorporeal Circulation - Case Report

“…The false aneurysmal wall lacks myocardial elements and communicates with the ventricle th rough a relatively small defec t: the cardiotomy incision. Independent of the o rigin of the false aneurysm, complications include rupt ure and fatal hemorrh age (5,22,24), co ngestive heart failure (3. 12) and erosion of adjacent structures (3,4,13,19).…”

Aneurismas ventriculares en una población de pacientes con cardiomiopatía chagásica

“…El aneurisma ventricular se define como una dilatación sacular y circunscrita del miocardio, con tejido fibroso no contráctil de espesor reducido, que incluye todas las capas de la pared cardíaca y con expansión sistólica, descrito por primera vez en 1757 por Hunter 3 . El ventrículo izquierdo (VI), con una geometría ovoidal, tiene puntos débiles en sus polos.…”