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Management of left ventricular pseudoaneurysm: A single-institution case series
John R. Spratt1, Christopher T. Holley1, Jennifer E. Witt1, Ranjit John2, Kenneth K. Liao2, Sara J. Shumway3
1MD, Resident in General Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
2MD, Associate Professor, Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
3MD, Professor, Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.

Article ID: 100027Z12JS2016
doi:10.5348/Z12-2016-27-CS-19

Address correspondence to:
Sara J. Shumway
MD, 420 Delaware St SE
Mayo Mail Code 207
Minneapolis, MN 55455

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How to cite this article:
Spratt JR, Holley CT, Witt JE, John R, Liao KK, Shumway SJ. Management of left ventricular pseudoaneurysm: A single-institution case series. J Case Rep Images Surg 2016;2:70–75.


Abstract
Introduction: Left ventricular (LV) pseudoaneurysms are a rare and challenging clinical problem. Defined as a contained rupture of the left ventricular wall and most commonly caused by myocardial infarction (MI), patients generally present with chest pain, congestive heart failure, or dyspnea. Diagnosis is usually achieved through use of either echocardiography or angiography. Management is generally operative.
Case Series: We sought to examine our experience in the management of LV pseudoaneurysms with the goal of describing the diverse presentation of this disease, along with our individualized management. We report a retrospective case series of four patients who presented to our center with LV pseudoaneurysm, all of which were managed operatively. All four patients underwent successful repair with 100% short-term survival.
Conclusion: Early diagnosis and an individualized operative approach is critical in the management of left ventricular pseudoaneurysm.

Keywords: Coronary artery disease, Left ventricular aneurysm, Left ventricular pseudoaneurysm, Left ventricular rupture, Myocardial infarction


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Author Contributions:
John R. Spratt – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Christopher T. Holley – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Jennifer E. Witt – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ranjit John – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kenneth K. Liao – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sara J. Shumway – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 John R. Spratt et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

John R. Spratt is a Resident in General Surgery at the University of Minnesota, Minneapolis. He earned undergraduate degree in mathematics and a master's degree in chemistry from Washington University in St. Louis and his medical degree from the Medical University of South Carolina, Charleston. His research interests include end-stage heart and lung disease, heart and lung transplantation, mechanical circulatory support, and mitral valve disease. He intends to pursue fellowship training in cardiovascular and thoracic surgery in future.



Christopher T. Holley is a Resident in General Surgery at the University of Minnesota, Charleston. He earned undergraduate degree in biology and his medical degree from Creighton University, Omaha. His research interests include myocardial recovery, left ventricular assist devices, and lung transplantation. He intends to pursue fellowship training in cardiovascular and thoracic surgery in future.



Jennifer E. Witt is a general surgeon in Duluth, Minnesota. She earned undergraduate and medical degrees from the University of Colorado, Boulder, Colorado. She completed her residency in general surgery at the University of Minnesota, Minneapolis.



Ranjit John is an Associate Professor in the Department of Surgery, Division of Cardiothoracic Surgery, at the University of Minnesota, Minneapolis. He completed his training in cardiovascular and thoracic surgery at New York-Presbyterian Hospital, Columbia University, New York. His research interests include mechanical circulatory support and heart transplantation.



Kenneth Liao is an Associate Professor in the Department of Surgery, Division of Cardiothoracic Surgery, at the University of Minnesota, Minneapolis. He completed his training in cardiovascular and thoracic surgery at the University of Minnesota, Minneapolis. His research interests include mechanical circulatory support, heart transplantation, and minimally invasive cardiac surgery.



Sara J. Shumway is a Professor in the Department of Surgery, Division of Cardiothoracic Surgery, at the University of Minnesota, Minneapolis. She completed her training in cardiovascular and thoracic surgery at Johns Hopkins University, Baltimore, Maryland. Her research interests include heart and lung transplantation.