A Boolean Dilemma: True or False Aneurysm?

Robert J Holtackers; Rachel M A Ter Bekke; Geertruida P Bijvoet; Suzanne Gommers; Amedeo Chiribiri; Roberto Lorusso

doi:10.1016/j.jaccas.2020.09.055

A Boolean Dilemma: True or False Aneurysm?

JACC Case Rep. 2020 Dec 23;3(1):112-116. doi: 10.1016/j.jaccas.2020.09.055. eCollection 2021 Jan.

Authors

Robert J Holtackers^{1

2

3}, Rachel M A Ter Bekke^{1

4}, Geertruida P Bijvoet⁴, Suzanne Gommers², Amedeo Chiribiri^{3

5}, Roberto Lorusso^{1

6}

Affiliations

¹ Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
² Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
³ School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.
⁴ Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
⁵ Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
⁶ Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.

Abstract

A feared complication of acute myocardial infarction is the formation of a cardiac pseudoaneurysm. We report a case of a gargantuan, arrhythmogenic left-ventricular pseudoaneurysm with contradictory morphological characteristics. The integrative use of high-resolution 3-dimensional magnetic resonance imaging and computed tomography proved essential for the diagnostic discrimination and successful therapeutic intervention. (Level of Difficulty: Advanced.).

Keywords: 3D, 3-dimensional; CT, computed tomography; ECG, electrocardiogram; IABP, intra-aortic balloon pump; ICD, implantable cardioverter-defibrillator; LGE, late gadolinium enhancement; LV, left ventricular; MRI, magnetic resonance imaging; V-A ECLS, veno-arterial extracorporeal life support; VT, ventricular tachycardia; computed tomography; echocardiography; false aneurysm; magnetic resonance imaging; myocardial infarction; pseudoaneurysm.

Publication types

Case Reports