Ventricular aneurysm is a rare complication of transmural acute myocardial infarction requiring multimodality imaging for assessment and potentially surgical intervention or implantable defibrillators.
This review highlights the role of multimodality imaging and a multidisciplinary approach, including surgery and medical therapy, for managing post-MI ventricular aneurysms.
Ventricular aneurysm represents a rare complication of transmural acute myocardial infarction, although other cardiac, congenital, or metabolic diseases may also predispose to such condition. Ventricular expansion includes all the cardiac layers, usually with a large segment involved. Adverse events include recurrent angina, reduced ventricular stroke volume with congestive heart failure, mitral regurgitation, thromboembolism, and ventricular arrhythmias. Multimodality imaging is paramount to provide comprehensive assessment, allowing for appropriate therapeutic decision-making. When indicated, surgical intervention remains the gold standard, although additional therapy (heart failure, anticoagulation, and advanced antiarrhythmic treatment) might be required. However, the STICH (Surgical Treatment for Ischemic Heart Failure) trial did not show any advantage from adding surgical ventricular reconstruction to coronary artery bypass surgery in terms of survival, rehospitalization or symptoms, compared with revascularization alone. Finally, implantable cardiac defibrillator may reduce the risk of fatal arrhythmias.
Lorusso et al. (Wed,) conducted a review in Postmyocardial Infarction Ventricular Aneurysm. Ventricular aneurysm is a rare complication of transmural acute myocardial infarction requiring multimodality imaging for assessment and potentially surgical intervention or implantable defibrillators.