Author + information
- Received August 13, 1984
- Revision received December 26, 1984
- Accepted January 9, 1985
- Published online July 1, 1985.
- Luigi Chiariello, MD, FACC*,a,
- Francesco Macrina, MD†,
- Quintilio Caretta, MD†,
- Francesco S. Leonardi Cattolica, MD†,
- Ugo Papalia, MD† and
- Benedetto Marino, MD†
- ↵aAddress for reprints: Luigi Chiariello, MD, Cardiac Surgery, II University of Rome School of Medicine, via Orazio Raimondo, 00 173 Rome, Italy.
A 68 year old man had a diaphragmatic myocardial infarction and 9 months later was admitted with severe congestive heart failure (functional class IV). Cardiac catheterization demonstrated a postinfarction pseudoaneurysm. Because of a massive left to right shunt (pulmonary to systemic flow ratio = 2.7), concomitant rupture of the ventricular septum was suspected. At surgery the pseudoaneurysm communicated with the right ventricle through two different orifices and with the left ventricle through another ostium. The ventricular septum was intact. Therefore, the shunt was extracardiac through the pseudoaneurysm (left ventricle → pseudoaneurysm → right ventricle). The unique combination of lesions allowed the patient to survive.
The false aneurysm was excised and primary repair was performed in the orifices of the right and left ventricular walls. The postoperative course was uneventful and 10 months later the patient was in functional class I.
This study was supported in part by Grant MPI 40% from the Ministero Pubblica Istruzione, Rome, Italy.
- Received August 13, 1984.
- Revision received December 26, 1984.
- Accepted January 9, 1985.
- American College of Cardiology Foundation