ArticleJACC. Case reports2025
Giant Left Ventricular Aneurysmal Dilatation With Coexisting Pseudoaneurysm After Anterior STEMI: Multimodality Imaging-Guided Repair.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLeft ventricular (LV) pseudoaneurysm is an uncommon but life-threatening complication after myocardial infarction. CASE SUMMARY: A 60-year-old man with untreated anterior ST-segment elevation myocardial infarction in 2021 developed a giant apical aneurysm (78 × 65 mm) and suspected pseudoaneurysm. Urgent surgery at that time revealed no rupture, and the aneurysm was left in situ. During follow-up under optimal medical therapy, multimodality imaging (transthoracic echocardiography, computed tomography, magnetic resonance imaging) documented progressive aneurysmal dilatation to 88 × 72 mm, and in 2025, a new pseudoaneurysm was identified within the aneurysmal segment. Surgical reconstruction with neo-apex formation (Fontan stitches, Dacron patch) was performed, restoring LV geometry. DISCUSSION: This case underscores the value of serial multimodality imaging for detecting delayed pseudoaneurysm formation and guiding surgical timing. Late repair can achieve excellent outcomes when based on accurate anatomical definition and multidisciplinary decision-making. TAKE-HOME MESSAGES: Longitudinal multimodality imaging detects late complications and optimizes timing. Accurate anatomical definition enables complex LV reconstruction even years after myocardial infarction.
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