An unusual case of postoperative giant left ventricular pseudoaneurysm

Pseudoaneurysms of the left ventricle are rare complications of acute myocardial infarction or cardiac surgery. Three years after aneurysmectomy of a true left ventricular aneurysm, a 66 years old man presented with clinical features of congestive heart failure. The echocardiography showed an extra large chamber next to the posterolateral region of the left ventricle with massive thrombus and severe mitral regurgitation. The diagnosis of pseudoaneurysm was made and was subsequently confirmed by radionuclid angiocardiography and surgical findings. Left ventricular pseudoaneurysm formation is a fairly unusual and serious complication of left ventricular aneurysmectomy with potential catastrophic results. Within the long period of time the pseudoaneurysm insidiously may become giant and may result in heart failure. Recognition of this rare complication of aneurysmectomy has therapeutic importance because surgical correction is necessary. Such pseudoaneurysm formation is easily recognized by two-dimentional echocardiography and radionuclic angiocardiogram. Careful echocardiographic examination is warranted for detecting such a complication in patients after cardiac surgery.