False aneurysm of the left ventricle

False aneurysm of the left ventricleIn this issue four cases are described [1][2][3][4] in which the authors illustrate their experience with the very uncommon surgical challenge of false (or pseudo) aneurysm of the left ventricle.Although this condition is seen infrequently, it should be recognised and distinguished from the common type of left ventricular aneurysm.It is said to have a propensity for rupture, and may cause symptoms of heart failure.It is eminently operable if it is approached with an understanding of its anatomy and certain characteristic features.6][7][8] Acute rupture of the myocardium is in fact quite common.Of patients dying of infarction, 17% have been found to have ruptured the heart through the infarcted area. 9Free wall rupture is four to five times more common than septal rupture, 9 presumably a simple reflection of the relative volumes of myocardium at risk, but it is usually immediately fatal.These are among the cases described as "EDM" (electromechanical dissociation) when they collapse some days after infarction, with a peak incidence at 3-5 days. 7The ventricle is beating but no output is generated because of tamponade.The patients with ruptured myocardium who survive to operation in the period soon after infarction, we see as the familiar acute septal rupture, loosely known as "infarct VSD".The UK Cardiac Surgical Register (of the Society of Cardiothoracic Surgeons of Great Britain and Ireland) records about 200 operations each year for this condition, with a mortality of 35-40%.This has changed very little over the past 20 years.Ruptured papillary muscle is also a familiar surgical on July 21, 2023 by guest.