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


False left ventricular aneurysm in patients with complicated forms of coronary heart disease: long-term results of surgical treatment

Authors: Akhmadov I.I., Alshibaya M.D., Mamalyga M.L., Cheishvili Z.M., Kalov A.R., Abzhuriev M.N., Zakargaev R.K., Alibekov D.Ya.

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

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2024-21-3-242-251

UDC: 616.124.2-007.64-089-06

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (3): 242-251

Quote as: Akhmadov I.I., Alshibaya M.D., Mamalyga M.L., Cheishvili Z.M., Kalov A.R., Abzhuriev M.N., Zakargaev R.K., Alibekov D.Ya. False left ventricular aneurysm in patients with complicated forms of coronary heart disease: long-term results of surgical treatment. Clinical Physiology of Circulation. 2024; 21 (3): 242–251 (in Russ.). DOI: 10.24022/1814- 6910-2024-21-3-242-251

Received / Accepted:  26.08.2024 / 12.09.2024

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Abstract

Objective. To analyze of long-term results of surgical treatment of false left ventricular aneurysm (LVA) in patients with complicated forms of coronary heart disease.

Material and methods. From 2008 to 2023, 32 reconstructive interventions were performed in patients with postinfarction LVA in the cardiac surgery department of the Bakoulev Center. There were 26 men and 6 women among the patients, the average age was 61±9.3 years. With an average EuroSCORE II value of 5.63%. Localization of false LVA: in 69% (22 patients) LV was formed after transmural infarction of the lower wall, and in 31% (10 patients) cases false LVA was formed on the anterolateral wall of the left ventricle.

Results. Hospital mortality was 18.7% (n = 6). Small cardiac output syndrome was the main cause of postoperative mortality (4 patients). 2 patients died from acute myocardial infarction in the immediate postoperative period (on days 1 and 9, respectively). Long-term results of surgical treatment in patients with false aneurysm of the left ventricle were studied in 26 patients ranging from 6 months to 15 years (mean follow-up period 6.36±3.81). During the follow-up period of 5 years, 4 patients died. Based on the data obtained, it can be stated that the survival rate without hospital mortality by the 5-year follow-up period was 89.74±5.6%. Survival data considering only cardiac causes of death and without hospital mortality rates: the first year of follow-up was 97.0%, the fifth year was 88.0%. According to clinical data, all patients noted an improvement in their condition after surgery.

Conclusion. The improvement in the clinical status of all patients, as well as satisfactory results of 3- and 5-year survival (92.4% and 91.7%, respectively), indicates the high effectiveness of reconstructive surgery in the complex treatment of patients with coronary heart disease with false aneurysm of the left ventricle.

References

  1. Глущенко В.А., Ираклиенко Е.К. Сердечно-сосудистая заболеваемость – одна из важнейших проблем здравоохранения. Медицина и организация здравоохранения. 2019; 4 (1): 56–63.
  2. Садыков Т.Т., Самко А.Н., Староверов И.И., Меркулов Е.В., Миронов В.М. Сочетание тромболитической терапии и чрескожных коронарных вмешательств в лечении острого инфаркта миокарда с подъемом сегмента ST. Атеросклероз и дислипидемии. 2012; 4: 78–85.
  3. Zoffoli G., Mangino D., Venturini A., Terrini A., Asta A., Zanchettin Ch., Polesel E. Diagnosing left ventricular aneurysm from pseudo- aneurysm: a case report and a review in literature. J. Cardiothorac. Surg. 2009; 4. DOI: 10.1186/1749-8090-4-11
  4. Yeo T.C., Malouf J.F., Oh J.K., Seward J.B. Clinical profile and outcome in 52 patients with cardiac pseudoaneurysm. Ann. Intern. Med. 1998; 128 (4): 299–305. DOI: 10.7326/0003-4819-128-4-199802150-00010
  5. Eren E., Bozbuga N., Toker M.E., Keles C., Rabus M.B., Yildirim O. et al. Surgical treatment of post-infarction left ventricular pseudoaneurysm: a two-decade experience. Tex. Heart Inst. J. 2007; 34 (1): 47–51. PMID: 17420793.
  6. Formica F., Mariani S., Singh G., D’Alessandro S., Messina L.A., Jones N. et al. Postinfarction left vent-ricular free wall rupture: a 17-year single-centre experience. Eur. J. Cardio-Thorac. Surg. 2018; 53 (1): 150–156. DOI: 10.1093/ejcts/ezx271
  7. Matteucci M., Ferrarese S., Mantovani V., Corazzari C., Cappabianca G., Messina C. et al. Surgical repair of left ventricular free-wall rupture complicating acute myocardial infarction: a single-center 30 years of experience. Front. Cardiovasc. Med. 2024; 10: 1348981. DOI: 10.3389/fcvm.2023.1348981
  8. Zhong Z., Song W., Zheng S., Liu S. Surgical and conservative treatment of post-infarction left ventricular pseudoaneurysm. Front. Cardiovasc. Med. 2022; 9: 801511. DOI: 10.3389/fcvm.2022.801511
  9. Дюжиков А.А., Поддубный А.В., Павлов А.В., Куликовских Я.В. Ложные аневризмы левого желудочка. Грудная и сердечно- сосудистая хирургия. 2008; 1: 53–59.
  10. Bisoyi S., Dash A.K., Nayak D., Sahoo S., Mohapatra R. Left ventricular pseudoaneurysm versus aneurysm a diagnosis dilemma. Ann. Card. Anaesth. 2016; 19 (1): 169–172. DOI: 10.4103/0971-9784.173042
  11. Faustino M., Ranchordás S., Abecasis J., Freitas A., Ferreira M., Gil V. et al. Left ventricular pseudoaneurysm – a challenging diagnosis. Pseudoaneurisma ventricular esquerdo – um desafio diagnóstico. Rev. Port. Cardiol. 2016; 35 (6): 373.e1–373.e3736. DOI: 10.1016/j.repc.2015.09.008
  12. Pollak H., Nobis H., Miczoc J. Frequency of left ventricular free wall ruptures complicating acute myocardial infarction since. The advent of thrombolysis. Am. J. Cardiol. 1994; 74: 184–186.
  13. Sanders J., Bowden T., Woolfe-Loftus N., Sekhon M., Aitken L.M. Predictors of health-related quality of life after cardiac surgery: a systematic review. Health Qual. Life Outcomes. 2022; 20 (1): 79. DOI: 10.1186/s12955-022-01980-4
  14. Scheenstra B., van Susante L., Bongers B.C., Lenssen T., Knols H., van Kuijk S. et al. The effect of teleprehabilitation on adverse events after elective cardiac surgery: a randomized controlled trial. J. Am. Coll. Cardiol. 2025; 85 (8): 488–800. DOI: 10.1016/j.jacc.2024.10.064
  15. Dogan K.H., Demirci S., Tavli L., Buken B. Pseudoaneurysm originating from left ventricle aneurysm: an autopsy case and review of literature. J. Forensic. Leg. Med. 2013; 20 (8): 941–943.
  16. Сокольская Н.О., Сливнева И.В., Копылова Н.С., Толстихина А.А. Интраоперационная чреспищеводная эхокардиографическая диагностика ложной аневризмы левого желудочка. Грудная и сердечно-сосудистая хирургия. 2013; 1: 32–34.
  17. Алшибая М.Д., Абжуриев М.Н., Чеишвили З.М., Амирбеков М.М., Закаргаев Р.К. Операции при постинфарктном разрыве свободной стенки левого желудочка сердца. Грудная и сердечно-сосудистая хирургия. 2023; 65 (3): 341–348. DOI: 10.24022/0236-2791-2023-65-3-341-348
  18. Сокольская Н.О., Алшибая М.М., Иванов А.В., Копылова Н.С. Метод интраоперационной чреспищеводной эхокардиографии в диагностике ложной аневризмы левого желудочка. Клиническое наблюдение. Анестезиология и реаниматология. 2020; 6: 96–101. DOI: 10.17116/anaesthesiology202006196
  19. Prêtre R., Linka A., Jenni R., Turina M.I. Surgical treatment of acquired left ventricular pseudoaneurysms. Ann. Thorac. Surg. 2000; 70 (2): 553–557. DOI: 10.1016/s0003-4975(00)01412-0
****
  1. Glushchenko V.A., Iraklienko E.K. Cardiovascular morbidity as one of the most important public health problems. Medicine and Healthcare Organization. 2019; 4 (1): 56–63 (in Russ.).
  2. Sadykov T.T., Samko A.N., Staroverov I.I., Merkulov E.V., Mironov V.M. Combination of thrombolytic therapy and percutaneous coronary interventions in the treatment of acute ST-elevation myocardial infarction. Atherosclerosis and Dyslipidemia. 2012; 4: 78–85 (in Russ.).
  3. Zoffoli G., Mangino D., Venturini A., Terrini A., Asta A., Zanchettin Ch., Polesel E. Diagnosing left ventricular aneurysm from pseudo- aneurysm: a case report and a review in literature. J. Cardiothorac. Surg. 2009; 4. DOI: 10.1186/1749-8090-4-11
  4. Yeo T.C., Malouf J.F., Oh J.K., Seward J.B. Clinical profile and outcome in 52 patients with cardiac pseudoaneurysm. Ann. Intern. Med. 1998; 128 (4): 299–305. DOI: 10.7326/0003-4819-128-4-199802150-00010
  5. Eren E., Bozbuga N., Toker M.E., Keles C., Rabus M.B., Yildirim O. et al. Surgical treatment of post-infarction left ventricular pseudoaneurysm: a two-decade experience. Tex. Heart Inst. J. 2007; 34 (1): 47–51. PMID: 17420793.
  6. Formica F., Mariani S., Singh G., D’Alessandro S., Messina L.A., Jones N. et al. Postinfarction left vent-ricular free wall rupture: a 17-year single-centre experience. Eur. J. Cardio-Thorac. Surg. 2018; 53 (1): 150–156. DOI: 10.1093/ejcts/ezx271
  7. Matteucci M., Ferrarese S., Mantovani V., Corazzari C., Cappabianca G., Messina C. et al. Surgical repair of left ventricular free-wall rupture complicating acute myocardial infarction: a single-center 30 years of experience. Front. Cardiovasc. Med. 2024; 10: 1348981. DOI: 10.3389/fcvm.2023.1348981
  8. Zhong Z., Song W., Zheng S., Liu S. Surgical and conservative treatment of post-infarction left ventricular pseudoaneurysm. Front. Cardiovasc. Med. 2022; 9: 801511. DOI: 10.3389/fcvm.2022.801511
  9. Dyuzhikov A.A., Poddubnyy A.V., Pavlov A.V., Kulikovskikh Ya.V. False aneurysms of the left ventricle. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2008; 1: 53–59 (in Russ.).
  10. Bisoyi S., Dash A.K., Nayak D., Sahoo S., Mohapatra R. Left ventricular pseudoaneurysm versus aneurysm a diagnosis dilemma. Ann. Card. Anaesth. 2016; 19 (1): 169–172. DOI: 10.4103/0971-9784.173042
  11. Faustino M., Ranchordás S., Abecasis J., Freitas A., Ferreira M., Gil V. et al. Left ventricular pseudoaneurysm – a challenging diagnosis. Pseudoaneurisma ventricular esquerdo – um desafio diagnóstico. Rev. Port. Cardiol. 2016; 35 (6): 373.e1–373.e3736. DOI: 10.1016/j.repc.2015.09.008
  12. Pollak H., Nobis H., Miczoc J. Frequency of left ventricular free wall ruptures complicating acute myocardial infarction since. The advent of thrombolysis. Am. J. Cardiol. 1994; 74: 184–186.
  13. Sanders J., Bowden T., Woolfe-Loftus N., Sekhon M., Aitken L.M. Predictors of health-related quality of life after cardiac surgery: a systematic review. Health Qual. Life Outcomes. 2022; 20 (1): 79. DOI: 10.1186/s12955-022-01980-4
  14. Scheenstra B., van Susante L., Bongers B.C., Lenssen T., Knols H., van Kuijk S. et al. The effect of teleprehabilitation on adverse events after elective cardiac surgery: a randomized controlled trial. J. Am. Coll. Cardiol. 2025; 85 (8): 488–800. DOI: 10.1016/j.jacc.2024.10.064
  15. Dogan K.H., Demirci S., Tavli L., Buken B. Pseudoaneurysm originating from left ventricle aneurysm: an autopsy case and review of literature. J. Forensic. Leg. Med. 2013; 20 (8): 941–943.
  16. Sokolskaya N.O., Slivneva I.V., Kopylova N.S., Tolstikhina A.A. Intraoperative transesophageal echocardiographic diagnosis of a false left ventricular aneurysm. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2013; 1: 32–34 (in Russ.).
  17. Alshibaya M.D., Abzhuriev M.N., Cheishvili Z.M., Amirbekov M.M., Zakargaev R.K. Surgery for postinfarction rupture of the left ventricular free wall of the heart. Grudnaya i Serdechno-Sosudistaya Khirurgiya. 2023; 65 (3): 341–348 (in Russ.). DOI: 10.24022/0236-2791-2023-65-3-341-348
  18. Sokolskaya N.O., Alshibaya M.M., Ivanov A.V., Kopylova N.S. Intraoperative transesophageal echocardiography in the diagnosis of left ventricular false aneurysm. Russian Journal of Anesthesiology and Reanimatology. 2020; 6: 96–101 (in Russ.). DOI: 10.17116/anaesthesiology202006196
  19. Prêtre R., Linka A., Jenni R., Turina M.I. Surgical treatment of acquired left ventricular pseudoaneurysms. Ann. Thorac. Surg. 2000; 70 (2): 553–557. DOI: 10.1016/s0003-4975(00)01412-0

About Authors

  • Islam I. Akhmadov, Junior Researcher, Postgraduate; ORCID
  • Mikhail D. Alshibaya, Dr. Med. Sci., Professor, Head of the Department of Surgical Treatment of Ischemic Heart Disease; ORCID
  • Maksim L. Mamalyga, Dr. Med. Sci., Leading Researcher; ORCID
  • Zurab M. Cheishvili, Cand. Med. Sci., Senior Researcher; ORCID
  • Astemir R. Kalov, Cand. Med. Sci., Junior Researcher; ORCID
  • Magomed N. Abzhuriev, Junior Researcher; ORCID
  • Rashid K. Zakargaev, Junior Researcher, Postgraduate; ORCID
  • Deni-Sultan Ya. Alibekov, Resident Physician; ORCID

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