A Case of Left Ventricle Aneurysm (LVA) with Ventricular Septal Perforation (VSP) after Inferior Myocardial Infarction

(Department of Thoracic Surgery, Ome Municipal General Hospital, Tokyo, Japan)

Dai Tasaki Nagahisa Oshima Toshizumi Shirai
Satoru Makita
A 68-year-old woman with a chief complaint of dyspnea was admitted in March, 2007. She had undergone percutaneous angioplasty of the right coronary artery in 2002. Elective surgery was advised because echocardiography, left ventricular cineangiography and 64-multidetector-row CT (64MDCT) had revealed a left ventricular aneurysm (LVA), a ventricular septal perforation (VSP) through the aneurysm, and three diseased coronary arteries. The aneurysm wall was located on the inferior wall, and this was incised longitudinally. The VSP was directly sutured using 4-0 polypropylene, and the aneurysm was closed with large patches, and pledgetted mattress and running sutures. The postoperative course was uneventful, and the patient was discharged on the 13th postoperative day. It is rare for LVA and VSP to be diagnosed simultaneously, but the risk of pseudo-false aneurysm of the left ventricle is high because of free wall rupture and septal wall perforation, and therefore surgical repair is recommended.
  Jpn. J. Cardiovasc. Surg. 38:208-211i2009j