Left ventricular free wall rupture and large pseudoaneurysm after percutaneous coronary intervention.

摘要

A 66-year-old man presented with dyspnea for 1 month. He had undergone percutaneous coronary intervention to the left anterior descending and circumflex coronary arteries 4 weeks ago. Three days after the procedure, the echocardio-gram showed myocardial free wall rupture and relatively small pseudoaneurysm formation at the posterior base of the heart. Surgical treatment was considered initially; however, the repair attempt was unsuccessful. Since then the dyspnea has worsened. The echocardiogram showed significant expansion of the pseudoaneurysm measuring 13x10 cm (Fig. 1 and supplementary data). Left ventriculography confirmed the presence of a large pseudoaneurysm which was three times the size of the left ventricle (supplementary data). Given the risk of rupture, surgical repair was scheduled again. The pseudoaneurysm was surgically repaired with a patch this time, but the patient expired during the early postoperative period.