Minimally Invasive Repair of a Pseudo-False Left Ventricular Aneurysm via Left Minithoracotomy

A pseudo-false aneurysm of the left ventricle is a rare pathological entity characterized by narrow communication with the ventricular cavity and partial preservation of myocardial tissue within the aneurysmal wall. Surgical intervention is generally recommended due to the risk of rupture. Herein we report a case of surgical treatment for an asymptomatic pseudo-false left ventricular aneurysm performed via a left minithoracotomy. Transthoracic echocardiography and contrast-enhanced computed tomography revealed a 16 × 16-mm aneurysm at the left ventricular apex with a narrow neck and partial residual myocardium, consistent with a pseudo-false aneurysm. Coronary angiography revealed no significant coronary artery stenosis, and left ventricular systolic function was preserved. Considering the size, location, and favorable peripheral vascular anatomy of the aneurysm, repair was performed through a left fifth intercostal minithoracotomy. Cardiopulmonary bypass was established via the femoral vessels, and direct closure of the aneurysm was completed under ventricular fibrillation. The postoperative course was uneventful, and the patient was discharged on postoperative day 9. This case suggests that the left minithoracotomy may be a feasible surgical option in carefully selected patients with pseudo-false ventricular aneurysms.