title: Left ventricular apical aneurysm associated with normal coronary arteries following cardiac surgery: echocardiographic features and differential diagnosis.
abstract: Left ventricular aneurysms mainly occur in patients with transmural myocardial infarction caused by left anterior descending coronary artery occlusion. Left ventricular apical aneurysm is rarely found in patients with normal coronary arteriograms, and even rarer in these patients following cardiac operations. We analyzed 37 patients with postoperative left ventricular apical aneurysm, including 1 case from our hospital and 36 cases from the literature; 23 cases (62%) had left ventricular apical true aneurysms and 14 cases (38%) had left ventricular apical pseudoaneurysms, all confirmed at surgery and/or angiography. All cases, with the exception of one, had previously undergone cardiac surgery under cardiopulmonary bypass with apical venting. Although left ventriculography is generally regarded as the gold standard for diagnosis of ventricular aneurysm, echocardiography is an accurate and sensitive method in the evaluation of left ventricular apical aneurysm. Differential diagnosis of left ventricular apical aneurysm includes takotsubo cardiomyopathy, post transapical approach for transcatheter aortic valve implantation, and left ventricular diverticulum.
authors.affiliation: Department of Ultrasonography, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hubei Provincial Key Laboratory of Molecular Imaging, Wuhan 430022, People's Republic of China.
authors.forename: Mingxing
authors.initials: M
authors.lastname: Xie
authors.forename: Hua
authors.initials: H
authors.lastname: Zhou
authors.forename: Tsung O
authors.initials: TO
authors.lastname: Cheng
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Xinfang
authors.initials: X
authors.lastname: Wang
authors.forename: Qing
authors.initials: Q
authors.lastname: Lu
authors.forename: Yali
authors.initials: Y
authors.lastname: Yang
authors.forename: Bobo
authors.initials: B
authors.lastname: Shi
authors.forename: Qingmei
authors.initials: Q
authors.lastname: Fu
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Cardiac surgery; Echocardiography; Left ventricular apical aneurysm; Takotsubo cardiomyopathy; Transcatheter aortic valve implantation; Ventricular aneurysm