晚期慢性左心室假性动脉瘤血栓形成。
Late Chronic Left Ventricular Pseudoaneurysm Thrombosis.
作者信息
Lin Jacopo, Saccocci Matteo, Cetinel Eren, Ancona Francesco, Geremia Giulia, Alfieri Ottavio, Maisano Francesco, De Bonis Michele
机构信息
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele Scientific Institute, Milan, Italy.
出版信息
JACC Case Rep. 2025 Aug 6;30(22):104425. doi: 10.1016/j.jaccas.2025.104425.
BACKGROUND
Left ventricular pseudoaneurysm (LVPA) is a rare but serious complication following myocardial infarction, often leading to thrombus formation and hemodynamic collapse.
CASE SUMMARY
We present 2 cases of LVPA in patients with a history of myocardial infarction. A 61-year-old man underwent surgical repair for a large apical LVPA with significant thrombus formation, and a 77-year-old woman with a posterolateral LVPA was treated with percutaneous exclusion. Echocardiography and cardiac computed tomography were used in the diagnosis in both cases, highlighting the delayed presentation of LVPA.
DISCUSSION
LVPA, though rare, poses a high risk for rupture and thrombotic complications. Early recognition is crucial for timely intervention. These cases are of interest owing to the large size of the pseudoaneurysms and the distinct therapeutic approaches used.
TAKE-HOME MESSAGE: LVPA can manifest years after myocardial infarction, and timely intervention, whether surgical or percutaneous, is key to improving outcomes in such cases.
背景
左心室假性动脉瘤（LVPA）是心肌梗死后一种罕见但严重的并发症，常导致血栓形成和血流动力学崩溃。
病例摘要
我们报告2例有心肌梗死病史的LVPA患者。一名61岁男性因巨大的心尖部LVPA伴大量血栓形成接受了手术修复，一名77岁女性的后外侧LVPA接受了经皮封堵治疗。两例均采用超声心动图和心脏计算机断层扫描进行诊断，突出了LVPA的延迟表现。
讨论
LVPA虽然罕见，但破裂和血栓形成并发症的风险很高。早期识别对于及时干预至关重要。由于假性动脉瘤体积大以及采用了不同的治疗方法，这些病例很有意义。
要点
LVPA可在心肌梗死后数年出现，及时干预，无论是手术干预还是经皮干预，都是改善此类病例预后的关键。
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