Key result
Pharmacotherapy alone fails to prevent giant LV aneurysm progression in a case, suggesting early surgery.
Why the study?
Is optimal medical therapy sufficient to prevent disease progression in a patient with a large inferobasal wall aneurysm causing severe mitral regurgitation?
Case Report (n=1)
Is optimal medical therapy sufficient to prevent disease progression in a patient with a large inferobasal wall aneurysm causing severe mitral regurgitation?
In cases of large inferobasal wall aneurysms causing severe mitral regurgitation, optimal medical therapy may be insufficient to prevent disease progression, suggesting early surgical intervention may be preferred.
May support early surgery in giant LV aneurysms; hypothesis-generating and should not yet change practice.
A case of a 64-year-old patient who was referred to interventional cardiology unit in order to qualify her to mitral valve repair is presented. Transthoracic echocardiography revealed a giant inferior wall basal aneurysm of the left ventricle (44 mm × 31 mm, 57 ml) and coronary angiography revealed chronic total occlusion of the proximal right coronary artery. The patient refused surgical treatment and was treated with pharmacotherapy alone. At 1 year follow-up, clear progression of the disease was observed. Based on this case study, we would cautiously suggest that in similar cases of large inferobasal wall aneurysms causing severe MR, OMT may be insufficient to prevent disease progression, and that early surgical intervention may be preferred.
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Hrycek et al. (2023) conducted a case report in Giant left ventricular inferior wall aneurysm (n=1). Pharmacotherapy (Optimal Medical Therapy) was evaluated on Disease progression. Pharmacotherapy alone was insufficient to prevent disease progression at 1-year follow-up in a patient with a giant left ventricular inferior wall aneurysm, suggesting early surgery may be preferred.
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