Image in cardiology
Giant left ventricular aneurysm after myocardial infarction
Aneurisma do ventrículo esquerdo gigante após enfarte do miocárdio
M. Elena Arnáiz-Garcíaa,
, Ana M. Arnáiz-Garcíab, Ashesh D. Patelc, Francisco J. Gutiérrez-Diezd, Juan F. Nistal-Herrerad, Javier Arnáize
Autor para correspondência
a Cardiac Surgery Department, University Hospital of Salamanca, Salamanca, Spain
b Internal Medicine Department, University Hospital “Marqués de Valdecilla”, Santander, Spain
c Internal Medicine Department, George Washington University School of Medicine, Washington DC , United States
d Cardiovascular Surgery Department, University Hospital “Marqués de Valdecilla”, Santander, Spain
e Radiology Department, University Hospital “Marqués de Valdecilla”, Santander, Spain
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Elena Arnáiz-García, Ana M. Arnáiz-García, Ashesh D. Patel, Francisco J. Gutiérrez-Diez, Juan F. Nistal-Herrera, Javier Arnáiz" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M. Elena" "apellidos" => "Arnáiz-García" "email" => array:1 [ 0 => "elearnaiz@hotmail.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" => "Ana M." "apellidos" => "Arnáiz-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ashesh D." "apellidos" => "Patel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Francisco J." 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"apellidos" => "Nistal-Herrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Javier" "apellidos" => "Arnáiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Cardiac Surgery Department, University Hospital of Salamanca, Salamanca, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Internal Medicine Department, University Hospital “Marqués de Valdecilla”, Santander, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Internal Medicine Department, George Washington University School of Medicine, Washington DC , United States" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Cardiovascular Surgery Department, University Hospital “Marqués de Valdecilla”, Santander, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Radiology Department, University Hospital “Marqués de Valdecilla”, Santander, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Aneurisma do ventrículo esquerdo gigante após enfarte do miocárdio" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1621 "Ancho" => 2161 "Tamanyo" => 653184 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Surgical view of large aneurysm of the left ventricular posterolateral wall. (B) Neck of left ventricular aneurysm. The fibrous wall of the aneurysm, the endocardium and the papillary muscles of the mitral valve can be seen. (C) Exclusion of the aneurysm using a bovine pericardial patch sutured to the edges of the myocardium. (D) Occlusion and reinforcement of sutures with Teflon bands.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 63-year-old male smoker with a known history of hypertension was admitted to our hospital due to a two-month history of progressive dyspnea on exertion. He had initially presented two months previously with an acute episode of exertional chest pain. In that episode, the ECG was unremarkable and no ST elevation was detected; no further work-up was done at that time. Since that episode, the patient continued to have exertional chest pain with progressive dyspnea and weakness.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On admission to our hospital, ECG changes consistent with a previous posterolateral myocardial infarction were seen. Echocardiography showed a severely dysfunctional left ventricle with a large posterolateral wall aneurysm. Coronary angiography revealed a severely stenosed left anterior descending artery. The patient underwent emergent cardiac surgery which confirmed a large aneurysm in the posterolateral wall of the left ventricle (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). During surgery, the endocardium and the papillary muscles of the mitral valve were seen through the neck of the aneurysm (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B). Surgical ventricular restoration and coronary revascularization were performed, and the left ventricular aneurysm was excluded using a pericardial bovine patch (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C). Subsequent reinforcement of ventricular tissues and sutures was carried out with Teflon bands (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D). A bypass of the left anterior descending coronary artery with the left internal mammary artery was performed for myocardial revascularization. The patient had an uneventful recovery and was discharged ten days after surgery.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical responsibilities</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 no patient data appear in this article.</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="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0030" 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 responsibilities" "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" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-09-08" "fechaAceptado" => "2012-10-11" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1621 "Ancho" => 2161 "Tamanyo" => 653184 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Surgical view of large aneurysm of the left ventricular posterolateral wall. (B) Neck of left ventricular aneurysm. The fibrous wall of the aneurysm, the endocardium and the papillary muscles of the mitral valve can be seen. (C) Exclusion of the aneurysm using a bovine pericardial patch sutured to the edges of the myocardium. (D) Occlusion and reinforcement of sutures with Teflon bands.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003200000005/v1_201308021350/S0870255113000772/v1_201308021350/en/main.assets" "Apartado" => array:4 [ "identificador" => "357" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Imagens em cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003200000005/v1_201308021350/S0870255113000772/v1_201308021350/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000772?idApp=UINPBA00004E" ]
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