Image in Cardiology
Cardiovascular imaging of a giant left ventricular aneurysm
Imagiologia cardiovascular de um aneurisma ventricular esquerdo gigante
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Almeida" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Gustavo" "apellidos" => "Lima da Silva" "email" => array:1 [ 0 => "gustavolssilva@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Catarina" "apellidos" => "Carvalheiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Pedro" "apellidos" => "Cardoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Arruda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Ângelo" "apellidos" => "Nobre" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Ana G." "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Serviço de Cardiologia, Hospital de Santa Maria, Centro Académico Médico de Lisboa, CCUL, Lisboa, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Serviço de Cirurgia Cardiotorácica, Hospital de Santa Maria, Centro Académico Médico de Lisboa, Lisboa, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagiologia cardiovascular de um aneurisma ventricular esquerdo gigante" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1134 "Ancho" => 992 "Tamanyo" => 174356 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Intraoperative photographs following median sternotomy: (A) large aneurysm of the left ventricular inferior wall; (B) wall thrombus removed from ventricular aneurysm; (C) aneurysm neck closed with a Dacron<span class="elsevierStyleSup">®</span> patch.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 73-year-old man with a history of coronary artery disease and inferoposterior myocardial infarction was referred for cardiology consultation with symptoms of chronic heart failure in NYHA class III.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Transthoracic echocardiography revealed a thrombus partially filling a giant pseudoaneurysm/aneurysm of the inferoposterior wall, causing significant deformation of the ventricular geometry (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>; <a class="elsevierStyleCrossRef" href="#sec0025">Videos 1–4</a>). Despite the size of the aneurysm, the subvalvular mitral apparatus was intact, with no regurgitation. Given the uncertainty surrounding the differential diagnosis, cardiac magnetic resonance imaging was performed, which confirmed a giant ventricular aneurysm (long axis 6.7 cm) containing a thrombus (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>; <a class="elsevierStyleCrossRef" href="#sec0030">Videos 5 and 6</a>), and anticoagulant therapy was begun. Myocardial perfusion scintigraphy excluded ischemia and confirmed necrosis of the inferoposterior territory. Preoperative cardiac catheterization showed chronic occlusion of the proximal right coronary artery but no significant left coronary disease, while ventriculography documented a large ventricular aneurysm (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>; <a class="elsevierStyleCrossRef" href="#sec0030">Video 7</a>). The patient underwent surgical repair of the aneurysm of the left ventricular inferior wall (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>) by partial aneurysmectomy under extracorporeal circulation, with removal of a large wall thrombus and closure of the aneurysm neck with a 2 cm × 3 cm Dacron<span class="elsevierStyleSup">®</span> patch (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>). The left ventricle was closed using continuous sutures. The postoperative period was uneventful and the patient was discharged home on the fifth postoperative day.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-12-01" "fechaAceptado" => "2015-01-01" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lima da Silva G, Carvalheiro C, Cardoso P, et al. Imagiologia cardiovascular de um aneurisma ventricular esquerdo gigante. Rev Port Cardiol. 2015;34:501–503.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0035" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia><elsevierMultimedia ident="upi0015"></elsevierMultimedia><elsevierMultimedia ident="upi0020"></elsevierMultimedia><elsevierMultimedia ident="upi0025"></elsevierMultimedia><elsevierMultimedia ident="upi0030"></elsevierMultimedia><elsevierMultimedia ident="upi0035"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:11 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1146 "Ancho" => 1401 "Tamanyo" => 156956 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Two-dimensional transthoracic echocardiography: (A) apical 4-chamber view showing no alterations; (B) apical 2-chamber view revealing a giant ventricular inferior wall aneurysm containing a thrombus; (C) modified apical 2-chamber view showing intact subvalvular mitral apparatus; (D) modified apical 3-chamber view showing a large ventricular posterior wall aneurysm containing a thrombus.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 779 "Ancho" => 1300 "Tamanyo" => 108329 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cardiac cine steady-state free precession magnetic resonance imaging: (A) long-axis view showing a giant ventricular aneurysm (long axis 6.7 cm) of the posterior wall (arrow) containing a thrombus; (B) short-axis view above the level of the papillary muscles showing a large ventricular aneurysm of the inferoposterior wall (arrow), containing a thrombus.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 938 "Ancho" => 997 "Tamanyo" => 95783 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ventriculography showing a giant ventricular aneurysm, the arrows indicating its anatomical borders.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1134 "Ancho" => 992 "Tamanyo" => 174356 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Intraoperative photographs following median sternotomy: (A) large aneurysm of the left ventricular inferior wall; (B) wall thrombus removed from ventricular aneurysm; (C) aneurysm neck closed with a Dacron<span class="elsevierStyleSup">®</span> patch.</p>" ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 609481 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 5 => array:5 [ "identificador" => "upi0010" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 620475 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" ] "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 6 => array:5 [ "identificador" => "upi0015" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc3.mp4" "ficheroTamanyo" => 458548 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc3.m4v" "poster" => "mmc3.jpg" ] "flv" => array:5 [ "fichero" => "mmc3.flv" "poster" => "mmc3.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 7 => array:5 [ "identificador" => "upi0020" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc4.mp4" "ficheroTamanyo" => 645327 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc4.m4v" "poster" => "mmc4.jpg" ] "flv" => array:5 [ "fichero" => "mmc4.flv" "poster" => "mmc4.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 8 => array:5 [ "identificador" => "upi0025" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc5.mp4" "ficheroTamanyo" => 336004 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc5.m4v" "poster" => "mmc5.jpg" ] "flv" => array:5 [ "fichero" => "mmc5.flv" "poster" => "mmc5.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 9 => array:5 [ "identificador" => "upi0030" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc6.mp4" "ficheroTamanyo" => 377654 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc6.m4v" "poster" => "mmc6.jpg" ] "flv" => array:5 [ "fichero" => "mmc6.flv" "poster" => "mmc6.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 10 => array:5 [ "identificador" => "upi0035" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc7.mp4" "ficheroTamanyo" => 2350867 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc7.m4v" "poster" => "mmc7.jpg" ] "flv" => array:5 [ "fichero" => "mmc7.flv" "poster" => "mmc7.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003400000078/v1_201508050210/S2174204915001518/v1_201508050210/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000078/v1_201508050210/S2174204915001518/v1_201508050210/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915001518?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 27 | 26 | 53 |
| 2024 September | 40 | 18 | 58 |
| 2024 August | 49 | 27 | 76 |
| 2024 July | 26 | 24 | 50 |
| 2024 June | 36 | 25 | 61 |
| 2024 May | 46 | 22 | 68 |
| 2024 April | 28 | 25 | 53 |
| 2024 March | 53 | 18 | 71 |
| 2024 February | 26 | 21 | 47 |
| 2024 January | 36 | 21 | 57 |
| 2023 December | 30 | 26 | 56 |
| 2023 November | 29 | 20 | 49 |
| 2023 October | 29 | 16 | 45 |
| 2023 September | 30 | 20 | 50 |
| 2023 August | 36 | 17 | 53 |
| 2023 July | 39 | 17 | 56 |
| 2023 June | 34 | 9 | 43 |
| 2023 May | 39 | 24 | 63 |
| 2023 April | 29 | 9 | 38 |
| 2023 March | 42 | 19 | 61 |
| 2023 February | 49 | 38 | 87 |
| 2023 January | 48 | 14 | 62 |
| 2022 December | 48 | 19 | 67 |
| 2022 November | 61 | 32 | 93 |
| 2022 October | 45 | 17 | 62 |
| 2022 September | 47 | 26 | 73 |
| 2022 August | 47 | 33 | 80 |
| 2022 July | 59 | 28 | 87 |
| 2022 June | 42 | 17 | 59 |
| 2022 May | 33 | 36 | 69 |
| 2022 April | 31 | 23 | 54 |
| 2022 March | 26 | 23 | 49 |
| 2022 February | 46 | 23 | 69 |
| 2022 January | 55 | 18 | 73 |
| 2021 December | 34 | 32 | 66 |
| 2021 November | 48 | 45 | 93 |
| 2021 October | 50 | 33 | 83 |
| 2021 September | 33 | 31 | 64 |
| 2021 August | 33 | 41 | 74 |
| 2021 July | 27 | 25 | 52 |
| 2021 June | 22 | 19 | 41 |
| 2021 May | 32 | 33 | 65 |
| 2021 April | 46 | 26 | 72 |
| 2021 March | 52 | 17 | 69 |
| 2021 February | 67 | 13 | 80 |
| 2021 January | 35 | 19 | 54 |
| 2020 December | 41 | 6 | 47 |
| 2020 November | 41 | 7 | 48 |
| 2020 October | 21 | 11 | 32 |
| 2020 September | 47 | 9 | 56 |
| 2020 August | 35 | 8 | 43 |
| 2020 July | 54 | 8 | 62 |
| 2020 June | 39 | 6 | 45 |
| 2020 May | 38 | 6 | 44 |
| 2020 April | 39 | 11 | 50 |
| 2020 March | 40 | 11 | 51 |
| 2020 February | 75 | 36 | 111 |
| 2020 January | 40 | 7 | 47 |
| 2019 December | 43 | 4 | 47 |
| 2019 November | 23 | 9 | 32 |
| 2019 October | 40 | 7 | 47 |
| 2019 September | 66 | 7 | 73 |
| 2019 August | 36 | 9 | 45 |
| 2019 July | 33 | 9 | 42 |
| 2019 June | 39 | 18 | 57 |
| 2019 May | 45 | 14 | 59 |
| 2019 April | 24 | 18 | 42 |
| 2019 March | 97 | 14 | 111 |
| 2019 February | 110 | 14 | 124 |
| 2019 January | 79 | 12 | 91 |
| 2018 December | 50 | 12 | 62 |
| 2018 November | 119 | 9 | 128 |
| 2018 October | 217 | 13 | 230 |
| 2018 September | 84 | 19 | 103 |
| 2018 August | 40 | 17 | 57 |
| 2018 July | 55 | 14 | 69 |
| 2018 June | 69 | 8 | 77 |
| 2018 May | 96 | 16 | 112 |
| 2018 April | 82 | 4 | 86 |
| 2018 March | 96 | 4 | 100 |
| 2018 February | 54 | 9 | 63 |
| 2018 January | 76 | 5 | 81 |
| 2017 December | 86 | 10 | 96 |
| 2017 November | 50 | 10 | 60 |
| 2017 October | 38 | 8 | 46 |
| 2017 September | 42 | 14 | 56 |
| 2017 August | 41 | 17 | 58 |
| 2017 July | 37 | 14 | 51 |
| 2017 June | 41 | 10 | 51 |
| 2017 May | 59 | 18 | 77 |
| 2017 April | 45 | 1 | 46 |
| 2017 March | 70 | 39 | 109 |
| 2017 February | 113 | 2 | 115 |
| 2017 January | 63 | 1 | 64 |
| 2016 December | 47 | 12 | 59 |
| 2016 November | 51 | 6 | 57 |
| 2016 October | 61 | 6 | 67 |
| 2016 September | 83 | 6 | 89 |
| 2016 August | 29 | 3 | 32 |
| 2016 July | 41 | 5 | 46 |
| 2016 June | 13 | 2 | 15 |
| 2016 May | 22 | 4 | 26 |
| 2016 April | 33 | 18 | 51 |
| 2016 March | 40 | 30 | 70 |
| 2016 February | 72 | 40 | 112 |
| 2016 January | 54 | 28 | 82 |
| 2015 December | 43 | 24 | 67 |
| 2015 November | 60 | 22 | 82 |
| 2015 October | 55 | 32 | 87 |
| 2015 September | 82 | 31 | 113 |
| 2015 August | 222 | 104 | 326 |
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