The Annals of Thoracic Surgery, Vol 31, 259-265, Copyright © 1981 by The Society of Thoracic Surgeons
False aneurysm and pseudo-false aneurysm of the left ventricle: etiology, pathology, diagnosis, and operative management
S Stewart, R Huddle, I Stuard, BF Schreiner and JA DeWeese
Four patients are presented in whom either a false aneurysm or a
"pseudo-false" aneurysm of the left ventricle developed following a
myocardial infarction. False aneurysms of the left ventricle are unusual
and are distinctly different from the more common true aneurysms. A false
aneurysm is the result of a contained hematoma dissecting, into a
transmural infarct. It communicates with the left ventricle through a small
orifice. Previous descriptions of false aneurysms have stressed that their
wall consists of pericardium and mural thrombus and lack identifiable
epicardial or myocardial elements. Two pseudo-false aneurysms are
described. They communicated with the left ventricle through a small
orifice but their wall contained myocardial tissue. False aneurysms have a
tendency to rupture and therefore their presence alone is an indication for
operation. One of the pseudo-false aneurysms discussed ruptured into the
right ventricle. The operation for false aneurysm may be simpler than that
for true aneurysm since it might be possible to close the small
communication into the left ventricle without resecting the entire aneurysm
wall.
