Case Report
Giant Post-Infarction Left Ventricular Aneurysm of the Lateral Wall
Issue:
Volume 12, Issue 4, August 2026
Pages:
99-106
Received:
22 June 2026
Accepted:
3 July 2026
Published:
24 July 2026
DOI:
10.11648/j.ijcts.20261204.11
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Abstract: Background: Left ventricular aneurysm is an uncommon but important late mechanical complication of transmural myocardial infarction. Giant aneurysms can cause heart failure, angina, ventricular arrhythmia, thromboembolism, and diagnostic confusion with pseudoaneurysm or mediastinal masses. Case presentation: A 58-year-old male with a history of acute myocardial infarction in 2022 treated abroad by percutaneous coronary intervention/angioplasty with two stents in the left circumflex artery was evaluated for a large left ventricular outpouching. Earlier surgical advice had reportedly been declined, and the patient was managed medically until re-presentation in 2026. Echocardiography showed a large cystic aneurysmal lesion communicating with the posterior left ventricular wall through an approximately 3 cm neck, with left ventricular ejection fraction around 40%, mild left ventricular systolic dysfunction, grade I diastolic dysfunction, mild aortic regurgitation, and mild tricuspid regurgitation with an estimated right ventricular systolic pressure of approximately 36 mmHg. CT cardiac chamber imaging demonstrated cardiomegaly and a giant outpouching arising from the left lateral wall of the left ventricle, measuring approximately 131 x 90 x 115 mm with a 20 mm neck. CT coronary angiography showed mild plaque burden in the LAD, LCx, and RCA, with uncertain distal LCx stent patency. The patient underwent open surgical repair with exclusion of the aneurysmal cavity and ventricular reconstruction with primary multilayer closure of neck using Teflon felt under cardiopulmonary bypass. Conclusion: This case highlights the value of multimodality imaging for defining aneurysm size, neck anatomy, coronary status, and associated thoracic findings. Giant post-infarction aneurysms, especially when large, symptomatic, or anatomically high risk, require individualized heart-team assessment and often surgical reconstruction to restore ventricular geometry and reduce complications.
Abstract: Background: Left ventricular aneurysm is an uncommon but important late mechanical complication of transmural myocardial infarction. Giant aneurysms can cause heart failure, angina, ventricular arrhythmia, thromboembolism, and diagnostic confusion with pseudoaneurysm or mediastinal masses. Case presentation: A 58-year-old male with a history of acu...
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,
Sanjeev Devgarha
