Primary Infected Left Ventricular Pseudoaneurysm and the Use of Omental Flap

Abstract

A 55-year-old man with autoimmune deficiency syndrome presented with an infected left ventricular pseudoaneurysm and sepsis. The aneurysmectomy consisted of a Dor-style pericardial patch plus debridement of the abscess cavities. The infected pseudoaneurysm recurred, much larger, within five months due to persistent infected abscess cavities. The second repair was done without a Dor-style patch and with an omental flap. No recurrence has occurred one year after the second repair, but the patient has asymptomatic, partial gastric herniation inside the pericardium. This is the first description of a primary infected left ventricular pseudoaneurysm. The omental flap contributed to the successful treatment.

The Utility of the Omentum Flap for Complex Intrathoracic Problems

“…Recent cases series have also reported successful salvage of LVAD with omentum flaps. 2,7,19,20,30 The Effect of Vasoconstrictors on Omentum Viability…”

“…The use of the omentum as either a pedicled [1][2][3][4][5] or free flap 6 for chest wall reconstruction has been described for several indications. [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Most of the available reports are limited to case reports and small case series. In addition, the frequent occurrence of hypotensive episodes either during surgery or postoperatively in this group of patients who have a high prevalence of medical morbidities and cardiovascular disease may put the transferred omentum in a state of inadequate perfusion either due to prolonged hypotensive episodes or due to the effect vasoconstrictor infusions used to normalize these episodes.…”