Advances in the diagnosis and treatment of left ventricular pseudoaneurysm
10.3760/cma.j.cn112434-20240830-00209
- VernacularTitle:左心室假性室壁瘤诊疗进展
- Author:
Daxin YANG
1
;
Shanliang CHEN
1
;
Shibin SUN
1
;
Huaixue MI
1
;
Hongxin LI
1
Author Information
1. 山东第一医科大学第一附属医院 山东省千佛山医院心外科，济南 250014
- Publication Type:Journal Article
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(5):315-320
- CountryChina
- Language:Chinese
-
Abstract:
Left ventricular pseudoaneurysm(LVPA) is a rare type of abnormal ventricular wall bulge formed by injury to the inner wall of the left ventricle. The exterior wall only consists of epicardium or/and pericardium. In a systematic literature review, myocardial infarction(55%), surgery(33%), and trauma(7%) are the top three associations. Being affected by the high pressure of the left ventricle, LVPA has the risk of enlargement and rupture, which can lead to sudden death. The treatment of LVPA consists of three main modalities: medication, surgery, and transcatheter closure. In the past, surgery was the preferred treatment for LVPA, but the surgery was highly invasive, traumatic, and associated with increased risks. In recent years, transcatheter closure has been developed and applied clinically with good results. The benefits of minimal invasiveness and quick recovery have emerged as a popular treatment for LVPA. Currently, the etiology, formation, and treatment of LVPA are not clearly defined. Large-sample studies and authoritative guidelines to guide the treatment are scarce. The timing, imaging modality, and access routes to LVPA for both surgery and transcatheter closure are still controversial. In this article, we review the relevant literatures and draw the following conclusions as: (1) Diagnostic workup is essential for anatomical characterization of LVPA, which is mandatory to guide the decision on surgical methods.(2) For a subset of patients with LVPA and a well-defined fibrotic neck, and deemed at high surgical risk, transcatheter closure of the cavity has been described with encouraging results.
