Left ventricular pseudoaneurysm as a late complication of incomplete surgical stab wound repair, a case report

Ahmadali  khalili; Naser Safaei; Razieh  Parizad; Amir  Faravan; Mehran  Rahimi

doi:10.18502/cbj.v3i1.13466

Ahmadali khalili Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Naser Safaei Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Razieh Parizad Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Amir Faravan Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Mehran Rahimi Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/cbj.v3i1.13466

Keywords: Left ventricular, Pseudoaneurysm, Penetrating trauma

Abstract

Objectives: Left ventricular pseudoaneurysm (LVP) is a rare but life-threatening condition caused by rupture of the free wall of the ventricle. The ventricular wall is surrounded by adherent pericardium and scar tissue, lacking myocardial tissue. In this case study, an 18-year-old man, experiencing syncope, shortness of breath, dizziness, and pleuritic chest pain (CP) was admitted to the emergency department. Five months earlier, he had a penetrating chest trauma that damaged the pericardium and ventricular wall and underwent a left thoracotomy. Transthoracic echocardiography (TTE) identified a large 10*10 cm pseudoaneurysm in the apicolateral region of the ventricle. Considering the confirmed diagnosis of delayed left ventricular pseudo aneurysm, surgical intervention was deemed necessary. The patient went under general anesthesia, and cannulation of the artery and femoral vein and cardiopulmonary bypass (CPB) were performed. Open heart surgery was then performed through a midline sternotomy to excise the LVP and repair the ventricles. After transfer to the intensive care unit and subsequent extubation, the patient was transferred to the surgical ward and discharged in good condition.

Conclusions: This case report highlights the importance of timely diagnosis and appropriate treatment to save the lives of patients given the rapid spread observed in LVP cases.