Giant postinfarction posterolateral left ventricular aneurysm, complicated by mitral insufficiency

Abstract

Ischemic heart disease holds the leading position in the structure of cardiovascular diseases. Early reperfusion therapy for acute myocardial infarction led to a decrease in mortality and severe complications of coronary artery disease. Despite advances in the treatment of coronary artery disease, dilatation and remodeling of the left ventricle develop in 20% of patients who have had a heart attack, leading to mitral insufficiency and systolic dysfunction of the left ventricle. Aneurysm of the left ventricle is a delayed severe complication of myocardial infarction, which significantly worsens the prognosis. Large aneurysms of the left ventricle cause progressive dilatation of the left ventricle, its volumetric overload with an increase in wall tension in the non-infarction zone, decreased functional characteristics of the left ventricle, thrombosis in the aneurysm cavity, life-threatening arrhythmias, and sudden death. Postinfarction left ventricular remodeling can lead to secondary mitral regurgitation, which is an independent predictor of mortality in the longterm period. Surgical treatment of coronary heart disease and its complications is one of the main problems of modern cardiovascular surgery.

Keywords

• coronary artery disease
• coronary artery disease complications
• postinfarction left ventricular aneurysm
• ischaemic mitral regurgitation
• myocardial revascularization
• left ventricular aneurysm repair
• mitral valve replacement