Left ventricular aneurysm in a four-year-old child: a diagnostic challenge

Fatal Left Ventricular Aneurysm in a 13 Years Old Male Child: A Case Report

Background

A pouch protruding from the free wall of the left ventricle may be either a congenital ventricular diverticulum or congenital ventricular aneurysm. Congenital ventricular aneurism is a ventricular protuberance which is a kinetic or dyskinetic and on histology is predominantly fibrous tissue with no organized myocardium. Common clinical presentations of congenital ventricular aneurism are arrhythmia, rupture and heart failure.

Case Detail

A 13 year old patient presented with shortness of breath, fever, orthopnea of two pillows and paroxysmal nocturnal dyspnea of one week duration. Echocardiography revealed cystic mass seen at the apex of the heart communicating with left ventricle, with communicating defect and flow on color Doppler study. CT scan showed ventricular aneurism at the apex. The patient was managed for heart failure and passed away after few hours' of establishing diagnosis.

Conclusion

Congenital ventricular aneurysm is a rare condition which needs careful diagnosis for subsequent management.

Left ventricular assist device implantation with concomitant left ventricular reconstruction without patchplasty

In this case report, we describe a 66-year-old patient with a massive LV aneurism which resulted after myocardial infarction. Due to severe LV function impairment, it was decided to perform left ventricular reconstruction surgery and, at the same time, left ventricular assist device implantation as a bridge to transplantation. The entire procedure was completed without using any patch material. The patient had an uneventful recovery and was discharged home after 18 days. After 1-year follow-up no adverse events were observed.