Surgical management and outcome of left ventricular pseudoaneurysm: our 11-year experience

INTRODUCTION: Left ventricular (LV) pseudoaneurysm is an uncommon condition with a high risk of death due to spontaneous rupture. The symptoms are nonspecific and diagnosis is often delayed. Surgical repair is the treatment of choice despite associated operative mortality. AIM: Here we present a retrospective analysis of our experience in managing LV pseudoaneurysms over an 11-year period. MATERIAL AND METHODS: Between May 2009 and April 2020, 7 patients (6 males and 1 female) with LV pseudoaneurysm underwent surgical repair at our center. Hospital records were accessed to obtain relevant clinical information and treatment outcomes. The mean age was 41.86 years (range: 7-73 years). Etiologies were post-myocardial infarction (4 patients) and prior endocarditis/pericarditis (3 patients). Pseudoaneurysms were posterobasal in 4 patients and apical in 3 patients. All the patients underwent surgical repair with resection of pseudoaneurysm and patch repair of the ventricular wall defect. RESULTS: All patients tolerated surgery well with no perioperative mortality or morbidity. Clinical condition and echocardiographic findings remained stable in all patients over their follow-up period (3 months to 3 years). Mortality occurred in a 73-year-old patient with post-MI posterobasal pseudoaneurysm, 15 months after surgery due to acute exacerbation of chronic obstructive pulmonary disease. CONCLUSION: LV pseudoaneurysm is an entity that carries a high mortality risk. Timely diagnosis and early surgical intervention significantly improve the outcome.