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“TO-AND-FRO” FLOW OF LEFT VENTRICULAR PSEUDOANEURYSM
A604 JACC March 17, 2015 Volume 65, Issue 10S
FIT Clinical Decision Making “To-and-Fro” Flow of Left Ventricular Pseudoaneurysm Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision Making: Heart Failure and Cardiomyopathies Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1109-145 Authors: M Chadi Alraies, Hirad Yarmohammadi, Fahad Iqbal, Syed Abidi, Uma Valeti, University of Minnesota, Minneapolis, MN, USA A 57-year-old homeless man with known coronary artery disease presented with new shortness of breath on moderate exertion. He was recently discharged from the hospital after inferolateral myocardial infarction with three-vessel disease. At that point, left circumflex was determined to be the culprit vessel and was treated with angioplasty with no stenting giving his limited health coverage. On arrival, exam was significant for blood pressure 90/34 mmHg, and 109/min pulse rate with elevated jugular venous pressure to 12 cm H2O and S3 gallops. Up on work up, an extensive lateral wall infarct with free wall rupture into a large pseudoaneurysm sac (4.7 x 9.0 x 10.0 cm) was identified by transthoracic echocardiography, and cardiac magnetic resonance imaging (CMR). The pseudoaneurysm contains extensive layered thrombus burden. “To-and-fro flow between the left ventricle and the pseudoaneurysm sac was clearly evident by Doppler transthoracic echocardiography. Patient was referred for surgical repair. Intra-operatively, large clots were removed from the pseudoaneurysm and left ventricular free wall was performed successfully using a bovine pericardial patch to repair the defect. The aneurysm sac was then sutured around this to buttress the closure. Subsequently, the patient made an uneventful recovery.
FIT Clinical Decision Making “To-and-Fro” Flow of Left Ventricular Pseudoaneurysm Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision Making: Heart Failure and Cardiomyopathies Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1109-145 Authors: M Chadi Alraies, Hirad Yarmohammadi, Fahad Iqbal, Syed Abidi, Uma Valeti, University of Minnesota, Minneapolis, MN, USA A 57-year-old homeless man with known coronary artery disease presented with new shortness of breath on moderate exertion. He was recently discharged from the hospital after inferolateral myocardial infarction with three-vessel disease. At that point, left circumflex was determined to be the culprit vessel and was treated with angioplasty with no stenting giving his limited health coverage. On arrival, exam was significant for blood pressure 90/34 mmHg, and 109/min pulse rate with elevated jugular venous pressure to 12 cm H2O and S3 gallops. Up on work up, an extensive lateral wall infarct with free wall rupture into a large pseudoaneurysm sac (4.7 x 9.0 x 10.0 cm) was identified by transthoracic echocardiography, and cardiac magnetic resonance imaging (CMR). The pseudoaneurysm contains extensive layered thrombus burden. “To-and-fro flow between the left ventricle and the pseudoaneurysm sac was clearly evident by Doppler transthoracic echocardiography. Patient was referred for surgical repair. Intra-operatively, large clots were removed from the pseudoaneurysm and left ventricular free wall was performed successfully using a bovine pericardial patch to repair the defect. The aneurysm sac was then sutured around this to buttress the closure. Subsequently, the patient made an uneventful recovery.