Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Surgical treatment of pseudoaneurysms of the left ventricle in patients with complicated forms of coronary artery disease

Authors: Akhmadov I.I., Alshibaya M.D., Mamalyga M.L., Zakargaev R.K., Kalov A.R.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2023-20-3-207-212

UDC: 616.124.2-007.64+616.12-008.46]-089

Link: Clinical Physiology of Blood Circulaiton. 2023; 3 (20): 207-212

Quote as: Akhmadov I.I., Alshibaya M.D., Mamalyga M.L., Zakargaev R.K., Kalov A.R. Surgical treatment of pseudoaneurysms of the left ventricle in patients with complicated forms of coronary artery disease. Clinical Physiology of Circulation. 2023; 20 (3): 207–12 (in Russ.). DOI: 10.24022/1814-6910-2023-20-3-207-212

Received / Accepted:  28.07.2023 / 11.09.2023

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Abstract

Despite the continuous improvement of modern methods of prevention and treatment of cardiovascular diseases, this pathology today remains the main cause in the structure of total mortality in many developed countries of the world. Moreover, ischemic heart disease plays a key role among the most common cardiac diseases. The most severe manifestation of coronary heart disease is myocardial infarction. This is one of the main causes of life-threatening complications and mortality in patients with coronary heart disease. In addition, one of the most dangerous complications of acute myocardial infarction (AMI) is associated with rupture of the free wall of the left ventricle and extensive hemorrhage into the pericardium, which leads to instant death, with more than 60% of cases occurring in the prehospital period. A false aneurysm also has characteristic features that distinguish it from both RSLJ and a true left ventricular aneurysm.

Pseudoaneurysm of the left ventricle (PALV) is a very rare but potentially lethal mechanical complication of AMI. According to a number of authors, the incidence of pseudoaneurysms ranges from 0.3–0.5% of all cases of MI. However, in general, MI is burdened with high mortality, often associated with rupture of the false cavity, which leads to catastrophic and often irreversible consequences. Untimely diagnosis and assistance to patients with pseudoaneurysms of the left ventricle are associated with the rare occurrence of this pathology and often the asymptomatic nature of the course of the disease. Timely diagnostic examination is necessary, first of all, for anatomical characteristics of LV rupture and decision-making on surgical access and technique of pseudoaneurysm plasty. This is extremely important to avoid a fatal outcome, since the vast majority of pseudoaneurysms are extremely unstable and often require urgent surgical intervention. Clinically, pseudoaneurysm is manifested by the development of heart failure and arrhythmia, with a significant decrease in the quality of life. The results of surgical treatment of PALV can be considered acceptable, especially given the high mortality associated with the occurrence of a pseudoaneurysm rupture.

Although the resection of a pseudoaneurysm of the left ventricle remains a difficult surgical task, however, in most patients it is possible to achieve acceptable results. Surgical intervention is especially justified in cases where pseudoaneurysms are large or dilated, as they are prone to fatal rupture.

About Authors

  • Islam I. Akhmadov, Postgraduate; ORCID
  • Mikhail D. Alshibaya, Dr. Med. Sci., Professor, Head of the Department of Surgical Treatment of Coronary Heart Disease; ORCID
  • Maksim L. Mamalyga, Dr. Med. Sci., Leading Researcher; ORCID
  • Rashid K. Zakargaev, Junior Researcher, Postgraduate; ORCID
  • Astemir R. Kalov, Cand. Med. Sci., Junior Researcher; ORCID

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