Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Case Report

Volume 7, Number 1, February 2016, pages 32-35

Left Ventricular Pseudoaneurysm Following Inferior Myocardial Infarction: A Case for Conservative Management

Figure 1. Transthoracic echocardiogram demonstrating left ventricular pseudoaneurysm (arrow) in the distal inferolateral wall.

Figure 2. Cardiac computed tomography demonstrating a 1 × 2 cm outpouching along the inferolateral left ventricular wall at the mid cavity level in sagittal (I, II), coronal (III), axial (IV) and three-dimensionally reconstructed (V) views, consistent with pseudoaneurysm (arrows). RV: right ventricle; LV: left ventricle; AR: aortic root.

**Table 1.** Select Case Series Reviewing the Natural History and Treatment Outcomes of Left Ventricular Pseudoaneurysms
Authors	Study type	n	Age, years	Type and location, %	Causes of pseudoaneurysm, %	Management type, n	Follow-up period	Mortality findings
Yeo et al, 1998 [3]	Retrospective case series	52	Mean 48 ± 28	Left ventricle Inferior/posterolateral, 35 Sub-MV, 8 Subaortic, 6 Right ventricle RVOT, 25	Surgery, 58 MI, 42	Surgical, 42 Medical, 10	Median of 2.3 years	Surgical mortality 31% at 2.3 years Medical 60% at 2.3 years (no deaths due to rupture)
Frances et al, 1998 [1]	Systematic review	244	Median 60	Left ventricle Posterior, 43 Lateral, 28 Apical, 24 Inferior, 19 Anterior, 18 Basal, 14	MI, 55 Surgery, 33 Trauma, 7 Infection, 5	Surgical, 193 Medical, 51	1 - 10 years	Surgical post-operative mortality < 3 days 23%, remainder alive till about 4 years; Medical mortality at < 1 week, 48%, 61% at 1 year, 84% at 5 years, 94% at 10 years
Pretre et al, 2000 [5]	Retrospective case series	10	Mean 66	Left ventricle Inferior, 80 Lateral, 10 Anterior, 10	MI, 70 Surgical, 30	Surgical, 10	Median 45 months	Surgical mortality 28% in post-MI group; overall 30%
Moreno et al, 2003 [11]	Retrospective case series	10	Mean 63 ± 12	Left ventricle Inferior, 6 Anterior, 3 Anterior/inferior, 1	MI, 10	Surgical, 1 Medical, 9	Mean 3.8 years	Medical mortality at 4 years 10%
Atik et al, 2007 [4]	Retrospective case series	30	Mean 68 ± 8	Left ventricle Posterior, 39 Lateral, 29 Inferior, 21 Anterior, 11	MI, 100	Surgical, 30	Mean 52 ± 37 months	Surgical mortality 20% immediate and 27%, 41%, and 55% at 1, 5, and 8 years

Table 1. Select Case Series Reviewing the Natural History and Treatment Outcomes of Left Ventricular Pseudoaneurysms

Authors

Study type

Age, years

Type and location, %

Causes of pseudoaneurysm, %

Management type, n

Follow-up period

Mortality findings

Yeo et al, 1998 [3]

Retrospective case series

Mean 48 ± 28

Left ventricle
Inferior/posterolateral, 35
Sub-MV, 8
Subaortic, 6
Right ventricle
RVOT, 25

Surgery, 58
MI, 42

Surgical, 42
Medical, 10

Median of 2.3 years

Surgical mortality 31% at 2.3 years
Medical 60% at 2.3 years (no deaths due to rupture)

Frances et al, 1998 [1]

Systematic review

244

Median 60

Left ventricle
Posterior, 43
Lateral, 28
Apical, 24
Inferior, 19
Anterior, 18
Basal, 14

MI, 55
Surgery, 33
Trauma, 7
Infection, 5

Surgical, 193
Medical, 51

1 - 10 years

Surgical post-operative mortality < 3 days 23%, remainder alive till about 4 years;
Medical mortality at < 1 week, 48%, 61% at 1 year, 84% at 5 years, 94% at 10 years

Pretre et al, 2000 [5]

Retrospective case series

Mean 66

Left ventricle
Inferior, 80
Lateral, 10
Anterior, 10

MI, 70
Surgical, 30

Surgical, 10

Median 45 months

Surgical mortality 28% in post-MI group; overall 30%

Moreno et al, 2003 [11]

Retrospective case series

Mean 63 ± 12

Left ventricle
Inferior, 6
Anterior, 3
Anterior/inferior, 1

MI, 10

Surgical, 1
Medical, 9

Mean 3.8 years

Medical mortality at 4 years 10%

Atik et al, 2007 [4]

Retrospective case series

Mean 68 ± 8

Left ventricle
Posterior, 39
Lateral, 29
Inferior, 21
Anterior, 11

MI, 100

Surgical, 30

Mean 52 ± 37 months

Surgical mortality 20% immediate and 27%, 41%, and 55% at 1, 5, and 8 years