Diagnosis and management of the left ventricularfibromuscular aneurysm with a free-floating thrombus:clinical case and review

Authors: Golukhova E.Z., Alshibaya M.M., Mrikaev D.V., Mashina T.V., Lifanova L.S.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-2-190-199

For citation: Golukhova E.Z., Alshibaya M.M., Mrikaev D.V., Mashina T.V., Lifanova L.S. Diagnosis and management of the left ventricular fibromuscular aneurysm with a free-floating thrombus: clinical case and review. Creative Cardiology. 2019; 13 (2): 190–9 (in Russ.). DOI: 10.24022/1997-3187-2019-13-2-190-199

Received / Accepted:  28.05.2019/31.05.2019

Keywords: myocardial infarction thrombosis of the left ventricle postinfarction ventricular aneurysm

Full text:  

 

Abstract

Thrombosis of the left ventricular cavity is one of the complications of acute myocardial infarction with ST segment elevation, which may be a risk factor for systemic embolism. Nowadays there are different methods to reveal thrombosis of the left ventricle (LV). Contrast echocardiography is a common technology used in patients with postinfarction aneurysm. It allows to diagnose LV cavity thrombosis with high accuracy. This method is more specific and sensitive compared with the routine two-dimensional transthoracic echocardiography. The floating thrombus in the cavity of the postinfarction LV aneurysm is an absolute indication for the surgery. LV geometrical reconstruction with the synthetic patch is the optimal postinfarction LV aneurysm surgery. Due to this technique it is possible to reconstruct the LV geometry like the physiological geometry and reduce the risk of postoperative complications such as re-thrombosis of the LV and bleeding. In this article we discuss the clinical case of diagnosis and successful management of the LV fibromuscular aneurysm with a free-floating thrombus.

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About Authors

  • Elena Z. Golukhova, Dr Med. Sc., Academician of Russian Academy of Sciences, Head of Department, ORCID
  • Mikhail M. Alshibaya, Dr Med. Sc., Professor, ORCID
  • David V. Mrikaev, Cardiologist, Cand. Med. Sc., Researcher, ORCID
  • Tat’yana V. Mashina, Ultrasonic Diagnostics Physician, Cand. Med. Sc., Senior Researcher, ORCID
  • Lyubov’ S. Lifanova, Cardiologist, Junior Researcher, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery