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Q: pseudoaneurysm in her left ventricle, what does this mean? ( Answered,   1 Comment )
Question  
Subject: pseudoaneurysm in her left ventricle, what does this mean?
Category: Health > Conditions and Diseases
Asked by: puckman-ga
List Price: $10.00
Posted: 18 Jul 2002 15:13 PDT
Expires: 17 Aug 2002 15:13 PDT
Question ID: 42649
I have a friend that has a pseudoaneurysm in her left ventricle.  Can
you do some research on this topic and let me know what you find?  I
would like to know what this means, how it is treated, what the
related risks are, how common it is, how it occurs, and so on.

Note, for the $10 I am offering, I would expect someone getting paid
$20 per hour to spend 30 minutes on this, so if you are getting paid
close to this amount, I should expect a thorough answer :)
Answer  
Subject: Re: pseudoaneurysm in her left ventricle, what does this mean?
Answered By: lisaradha-ga on 20 Jul 2002 13:00 PDT
 
Hi,

Here is the material I found for you.  Your local public library
through inter-library loan will be able to get these articles for you.

1.  
Title: Transesophageal Two- and Three-Dimensional Echocardiographic
Diagnosis of Combined Left Ventricular Pseudoaneurysm and Ventricular
Septal Rupture
Author(s): Rajasekhar Nekkanti MD; Navin C. Nanda MD; Gilbert J.
Zoghbi MD; Osman Mukhtar MD; David C. McGiffin MD

Source: Echocardiography - Jnl Cardiovascular Ultrasound & Allied 

Techniques      Volume: 19 Number: 4 Page: p345 -- p349  

Publisher: Futura Publishing Company, Inc  

Abstract: Two- (2-D) and three-dimensional (3-D) transesophageal
echocardiography (TEE) were useful in making the diagnosis of combined
left ventricular pseudoaneurysm and ventricular septal rupture in an
elderly patient presenting with mediastinitis and worsening heart
failure following coronary artery bypass graft surgery. The diagnosis
was not suspected clinically. Three-dimensional TEE served to increase
the confidence level with which the diagnosis of this combined lesion
was made. Additionally, 3-D TEE proved superior to 2-D TEE in
assessing the size of the left ventricular rupture site.

2.
Title: Transesophageal Three-Dimensional Echocardiographic Assessment
of Left Ventricular Pseudoaneurysm

Author(s): Rajasekhar Nekkanti MD; Navin C. Nanda MD; Kamlesh G.
Ansingkar MD; David C. McGiffin MD

Source: Echocardiography - Jnl Cardiovascular Ultrasound & Allied
Techniques      Volume: 19 Number: 2 Page: p169 -- p172

Publisher: Futura Publishing Company, Inc  

Abstract: We report an adult patient with a left ventricular
pseudoaneurysm following an acute myocardial infarction in whom
three-dimensional (3-D) transesophageal echocardiography (TEE)
delineated clearly not only the location but also the size and shape
of the rupture site. The size of the rupture site measured by 3-D TEE
correlated well with the surgical measurements. Three-dimensional
images also showed a localized superior distortion of the lateral
aspect of the mitral annulus and left atrial wall produced by the
pseudoaneurysm. The resulting severe mitral regurgitation practically
disappeared after repair and decompression of the pseudoaneurysm.

3.
Eur J Echocardiogr 2002 Jun;3(2):111-6   
  
Usefulness of contrast agents in the diagnosis of left ventricular
pseudoaneurysm after acute myocardial infarction.

Moreno R, Zamorano JL, Almeria C, Rodrigo JL, Villate A, Serra V,
Alvarez L, Aubele A, Sanchez-Harguindey L.

Laboratory of Echocardiography, Hospital Clinico San Carlos, Madrid,
Spain

4.
Tex Heart Inst J 2002;29(2):122-5 Related Articles, Books, LinkOut  

Left ventricular pseudoaneurysm caused by coronary spasm, myocardial
infarction, and myocardial rupture.

Mahilmaran A, Nayar PG, Sheshadri M, Sudarsana G, Abraham KA.

Institute for Cardiac Treatment & Research, Southern Railway Hospital,
Ayanavaram, Chennai, India.

We report a very rare case of a 47-year-old man who had coronary spasm
that resulted in a silent myocardial infarction, a ruptured myocardial
wall, and a nonruptured left ventricular pseudoaneurysm. The patient
presented with a 6-month history of dyspnea on exertion, without
evidence of fixed coronary artery stenosis. Coronary angiography
showed severe coronary spasm of the left anterior descending and left
circumflex arteries; the spasm was relieved promptly by nitroglycerin.
Echocardiography and left ventricular angiography revealed the large
left ventricular pseudoaneurysm posterolateral to the left ventricle.
We performed surgical resection of the pseudoaneurysm and patch repair
of the ruptured left ventricular wall, with excellent results. We
present this case because of the highly unusual sequence of events.
Early surgical intervention resulted in the patient's recovery.

There are many more articles on PubMed, the ones I have listed above
are from other health databases.  PubMed is free to search and if you
want more information, just ask your local librarian to get more
articles for your from PubMed.

I hope this helps,
lisaradha
Comments  
Subject: Re: pseudoaneurysm in her left ventricle, what does this mean?
From: surgeon-ga on 15 Sep 2002 23:16 PDT
 
a true aneurysm is a bulging of the wall due to damage from a heart
attack (cutting off blood to the muscle). A false aneurysm is quite
rare, and results from the complete rupture of the wall of the heart
(which most often is fatal) after which the blood from the rupture
solidifies enough to form a wall (a "false" wall, which is where the
"pseudo" comes from) around the area of rupture. A true aneurysm, if
small enough, might not require surgical treatment, but a false
aneurysm virtually always does because of the high chance of secondary
rupture of the false wall. The rupture of the wall of the heart is due
to a heart attack which causes death of the full thickness of the
heart muscle. When the attack causes only partial thickness death of
the muscle, the muscle will bulge out, but remains a "true" wall of
muscle -- a ventricular aneurysm, as opposed to the above-described
false, or pseudo aneurysm.

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