Surgical reconstruction of coexisting left ventricular aneurysm and pseudoaneurysm in a patient with ventricular tachycardia: a case report

Left ventricular (LV) aneurysm and pseudoaneurysm are rare but potentially life-threatening complications of myocardial infarction. Their coexistence poses significant diagnostic and surgical challenges.

A 69-year-old woman with type II diabetes, hypertension, and dyslipidaemia presented with sustained ventricular tachycardia while remaining haemodynamically stable. Multimodality imaging revealed a chronic myocardial infarction with complete right coronary artery occlusion, a large LV aneurysm, and a focal pseudoaneurysm. Urgent LV reconstruction using a Dacron patch was performed. The postoperative course was uneventful, with preserved sinus rhythm and improved ventricular function.

This case underscores the importance of comprehensive imaging to characterize complex post-infarction LV remodelling. Surgical exclusion of scarred myocardium effectively restored LV geometry, improved cardiac function, and reduced arrhythmic risk. The successful repair provides insight into the decision-making process regarding optimal timing and technique for LV reconstruction.