Incidence of left-ventricular thrombosis after acute transmural myocardial infarction. Comparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review. Weaver WD, Simes RJ, Betriu A, Grines CL, Zijlstra F, Garcia E, Grinfeld L, Gibbons RJ, Ribeiro EE, DeWood MA, Ribichini F. Published by Oxford University Press on behalf of European Society of Cardiology. Patients with large LV aneurysm associated with severe refractory LV impairment and LV thrombus should be considered for LV aneurysmectomy for prognostic benefit and symptom relief.Īneurysm Cardiac magnetic resonance Case report Left ventricular aneurysmectomy Myocardial infarction Thrombus. The importance of imaging post-large MI and follow-up imaging once thrombus resolution has occurred is crucial. He remained asymptomatic and maintained a significant improvement of his LV function to 47% at his 5 months scan. The patient underwent a resection of the LV aneurysm and thrombus. The presence of a large, organized thrombus filling the aneurysm complicated the case further. His echocardiogram on admission demonstrated severe LV systolic impairment of 23% (which had deteriorated from 40%) with a giant true aneurysm of the basal to mid-lateral wall, which resembled a Valentine heart. His Warfarin had been stopped after 6 months of treatment of a small LV thrombus, which was noted at the time of his initial infarction. Restoration of LV function by surgical resection of the infarcted LV wall is an option for a few complicated cases, with variable outcomes.Ī 66-year-old man presented with dyspnoea 2 years after his initial MI, which was treated with a drug-eluting stent to his left circumflex artery. If not adequately managed in a timely manner, this can result in life-threatening consequences. Late complications still pose a dilemma, such as deterioration of left ventricle (LV) function, LV aneurysms, and LV thrombus formation. Mortality from myocardial infarction (MI) has been decreasing since the introduction of primary percutaneous intervention.
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