AMA Category 1 Credit for Physicians Only.
ASRT CME is not available.
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The diagnosis is an inferior aneurysm. In these loops, the inferior aneurysm is seen in 2D and 3D. Sometimes an inferior aneurysm can be missed because of it's proximity to the base of the heart and behind the aortic valve and it's closeness to the TEE probe. In the TG 2CV, the aneurysm appears as an outpouching of the inferior wall at the base and sometimes the middle segement. In the ME 2CV the wall can be obscured by shadows, however, a similar appearance may occur. The myocardial wall is thinned, calcified, and dyskinetic. Spontaneous echo contrast may be seen in the aneurysm with or without thormbus formation which may obscure the thickness or contour of the aneurysmal wall or shape. Most left ventricular aneurysm occur from myocardial infarction although they can be congenital.
Indications for surgery involve complications from the aneursymal dilation. Excessive dilation can cause blood flow stasis and lead to thrombus formation which requires anticoagulation or an operation. Aneurysmal dilation can also cause right ventricular outflow obstruction. If the aneurysm causes pulmonary congestion then a surgical operation is indicated. The classic Cooley aneurysmectomy (linear suturing to close the aneurysm) or the Dor procedure can be used to treat the aneurysm and restore the LV to a more normal shape and function. The Dor procedure (suturing the aneurysm shut over a patch to close of the aneurysm) was more suitable for septal aneurysms than the Cooley technique.
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Surgical treatment of left ventricular aneurysm.
A case of ventricular septal aneurysm producing right ventricular outflow obstruction in an adult patient.
Three-dimensional transesophageal echocardiographic delineation of ventricular septal aneurysm producing right ventricular outflow obstruction in an adult.
Isolated congenital ventricular septal aneurysm in an adult--a case report.
Surgical treatment of post infarction left ventricular aneurysms: our experience with double breasting and Dor's repair.
Ventricular septal aneurysm: a complication of myocardial infarction.
Echocardiographic Features of Large Posterobasal Left Ventricular Aneurysms.