Skip to Main Content

++

Left ventricular aneurysm has been strictly defined as a distinct area of abnormal left ventricular diastolic contour with systolic dyskinesia or paradoxical bulging (Fig. 30-1).1,2 Yet, a growing number of authors favor defining left ventricular aneurysm more loosely as any large area of left ventricular akinesia or dyskinesia that reduces left ventricular ejection fraction.3–5 This broader definition has been justified by data suggesting that the pathophysiology and treatment may be the same for ventricular akinesia and for ventricular dyskinesia.4,6 However, recent studies suggest that the optimal treatment and outcomes of patients with akinetic segments versus dyskinetic segments might be different.7,8 Intraoperatively, a left ventricular aneurysm may also be identified as an area that collapses upon left ventricular decompression.3,6,9 True left ventricular aneurysms involve bulging of the full thickness of the left ventricular wall, whereas a false aneurysm of the left ventricle is, in fact, a rupture of the left ventricular wall contained by surrounding pericardium.

++
Figure 30-1
Graphic Jump Location

Diagrammatic distinction between aneurysm and other states of the left ventricle. (Reproduced with permission from Grondin P, Kretz JG, Bical O, et al: Natural history of saccular aneurysm of the left ventricle. J Thorac Cardiovasc Surg 1979; 77:57.)

++

Left ventricular aneurysms have long been described at autopsy, but left ventricular aneurysm was not recognized to be a consequence of coronary artery disease until 1881.10 The angiographic diagnosis of left ventricular aneurysm was first made in 1951.10 A congenital left ventricular aneurysm was first treated surgically by Weitland in 1912 using aneurysm ligation. In 1944, Beck11 described fasciae latae plication to treat left ventricular aneurysms. Likoff and Bailey12 successfully resected a left ventricular aneurysm through a thoracotomy in 1955 using a special clamp without cardiopulmonary bypass. The modern treatment era began in 1958 when Cooley et al.13 successfully performed a linear repair of a left ventricular aneurysm using cardiopulmonary bypass. More geometric ventricular reconstruction or restoration techniques were subsequently devised by Stoney et al.,14 Daggett et al.,15 Dor et al.,16 Jatene,17 and Cooley et al.18,19

++

The incidence of left ventricular aneurysm in patients suffering from myocardial infarction has varied between 10 and 35% depending on the definition and the methods used. Of patients undergoing cardiac catheterization in the CASS study, 7.6% had angiographic evidence of left ventricular aneurysms.20 The absolute incidence of left ventricular aneurysms may be declining because of the increased use of thrombolytics and revascularization after myocardial infarction.21,22

++

More than 95% of true left ventricular aneurysms reported in the English literature result from coronary artery disease and myocardial infarction. True left ventricular aneurysms also may result from trauma,23 Chagas' disease,24 or sarcoidosis.25 A very small number ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.