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Cardiology115 papers

Left ventricular aneurysm

Last edited: 4/22/2026

Overview

Left ventricular aneurysm (LVA) is a localized dilation of the ventricular wall resulting from myocardial infarction or other causes, often leading to impaired cardiac function and increased morbidity and mortality 15.

Diagnosis

  • Clinical Presentation: Often asymptomatic initially, but may present with heart failure symptoms, angina, or thromboembolic events 15.
  • Imaging Techniques:
  • - Echocardiography: Essential for initial detection and assessment; real-time 3D echocardiography improves accuracy 1122. - CT and MRI: Useful for detailed anatomical assessment and quantification of aneurysm size 286. - Radionuclide Imaging: Multiple-gated blood-pool imaging can aid in diagnosis but has limitations 3830.
  • Thrombus Detection: Cross-sectional echocardiography and radionuclide ventriculography are effective 3020.
  • Management

  • Surgical Interventions:
  • - Linear Ventriculoplasty: Conventional approach, but outcomes vary 1. - No-Patch Techniques: Aim to reduce recurrence of ventricular dilatation 34. - Endoventricular Patch Plasty: More physiologic repair method compared to linear closure 10. - Pacopexy Procedure: Alternative surgical technique with reported success 2.
  • Medical Management:
  • - Angiotensin-Converting Enzyme Inhibitors (ACE-I): May prevent late remodeling post-repair 9. - Antithrombotic Therapy: Essential for managing mural thrombi to prevent embolization 737.

    Special Populations

  • Pediatrics: Rare cases reported, including congenital and calcified aneurysms 3645.
  • Elderly: Higher risk of complications; careful risk stratification is crucial 1.
  • Comorbidities: Presence of comorbidities like heart failure influences surgical risk and outcomes 15.
  • Key Recommendations

  • Surgical Repair: Consider endoventricular patch plasty over linear closure for better long-term outcomes (Evidence: Moderate) 10.
  • Use of ACE-I: Post-surgery, initiate ACE-I to potentially prevent late ventricular remodeling (Evidence: Moderate) 9.
  • Thrombus Management: Aggressive antithrombotic therapy is necessary in patients with mural thrombi to reduce embolization risk (Evidence: Moderate) 37.
  • Comprehensive Imaging: Employ real-time 3D echocardiography for accurate assessment of LVA dimensions and function (Evidence: Moderate) 11.
  • Risk Stratification: Prior to surgery, rigorously assess patient risk factors including age and comorbidities to guide treatment decisions (Evidence: Expert opinion) 1.
  • References

    1 Tiemuerniyazi X, Song Y, Chen L, Zhang S, Ma H, Nan Y et al.. A Nomogram to Predict Patient Mortality After Linear Ventriculoplasty for Left Ventricular Aneurysm. Heart, lung & circulation 2026. link 2 Cui H, Wu Y, Wei S, Gao C, Jiang S. The Pacopexy procedure for left ventricular aneurysm: a 10-year clinical experience. Surgery today 2020. link 3 Evora PR, Bassetto S, Junior LA. A variant "no-patch" technique for surgery of left ventricular aneurysms. Asian cardiovascular & thoracic annals 2014. link 4 Hu SS, Fan HG, Zheng Z, Feng W, Wang W, Song YH et al.. Left ventricular reconstruction with no-patch technique: early and late clinical outcomes. Chinese medical journal 2010. link 5 Yavuzgil O, Gürgün C, Apaydin A, Cinar CS, Yüksel A, Kültürsay H. A giant inferoposterior true aneurysm of the left ventricle mimicking a pseudoaneurysm. The international journal of cardiovascular imaging 2006. link 6 Koszegi Z, Kolozsvari R, Varga J, Galuska L, Szuk T, Csapo K et al.. 99mTc-MIBI SPECT assessment of the effects of aneurysm resection on the left ventricular morphology. Acta cardiologica 2004. link 7 Matsubayashi K, Fedak PW, Mickle DA, Weisel RD, Ozawa T, Li RK. Improved left ventricular aneurysm repair with bioengineered vascular smooth muscle grafts. Circulation 2003. link 8 Martens S, Dietrich M, Ozaslan F, Wimmer-Greinecker G, Moritz A. Left ventricular thrombus capture by an intra-aortic filter device. The Thoracic and cardiovascular surgeon 2002. link 9 Nomoto T, Nishina T, Miwa S, Tsuneyoshi H, Maruyama I, Nishimura K et al.. Angiotensin-converting enzyme inhibitor helps prevent late remodeling after left ventricular aneurysm repair in rats. Circulation 2002. link 10 Doss M, Martens S, Sayour S, Hemmer W. Long term follow up of left ventricular function after repair of left ventricular aneurysm. A comparison of linear closure versus patch plasty. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 2001. link00868-5) 11 Qin JX, Jones M, Shiota T, Greenberg NL, Tsujino H, Firstenberg MS et al.. Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies. Journal of the American College of Cardiology 2000. link00793-2) 12 Petrank YF, Azhari H, Lessick J, Sideman S, Beyar R. Effect of aneurysmectomy on left ventricular shape and function: case studies. Medical engineering & physics 1999. link00078-8) 13 Mohan JC, Hygriv Rao B, Arora R, Nigam M. Calcified subaortic left ventricular aneurysm causing right pulmonary artery obstruction in a child. International journal of cardiology 1998. link00192-2) 14 Guez DH, Sideman S, Beyar R. Regional right ventricular endocardial motion in normal hearts and in hearts with left ventricular aneurysm: a three dimensional study. International journal of cardiac imaging 1997. link 15 Buck T, Hunold P, Wentz KU, Tkalec W, Nesser HJ, Erbel R. Tomographic three-dimensional echocardiographic determination of chamber size and systolic function in patients with left ventricular aneurysm: comparison to magnetic resonance imaging, cineventriculography, and two-dimensional echocardiography. Circulation 1997. link 16 Grossi EA, Chinitz LA, Galloway AC, Delianides J, Schwartz DS, McLoughlin DE et al.. Endoventricular remodeling of left ventricular aneurysm. Functional, clinical, and electrophysiological results. Circulation 1995. link 17 Moulton MJ, Downing SW, Creswell LL, Fishman DS, Amsterdam DM, Szabó BA et al.. Mechanical dysfunction in the border zone of an ovine model of left ventricular aneurysm. The Annals of thoracic surgery 1995. link00521-l) 18 Lu P, Liu X, Shi R, Mo L, Borer JS. Comparison of tomographic and planar radionuclide ventriculography in the assessment of regional left ventricular function in patients with left ventricular aneurysm before and after surgery. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 1994. link 19 Savage EB, Downing SW, Ratcliffe MB, Fallert M, Gupta KB, Tyson GS et al.. Repair of left ventricular aneurysm. Changes in ventricular mechanics, hemodynamics, and oxygen consumption. The Journal of thoracic and cardiovascular surgery 1992. link 20 Lawson CS, Venn GE, Webb-Peploe MM. Thrombus within a submitral left ventricular aneurysm: diagnosis on cross sectional echocardiography. British heart journal 1991. link 21 Valette HB, Bourguignon MH, Merlet P, Grégoire MC, Le Guludec D, Pascal O et al.. Improved detection of anterior left ventricular aneurysm with multiharmonic fourier analysis. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1990. link 22 Mangschau A, Geiran O, Rootwelt K, Laake B, Forfang K. Impairment in right ventricular performance after left ventricular aneurysm surgery. The Annals of thoracic surgery 1988. link64693-0) 23 Wang R, DeSantola JR, Reichek N, Edie R. An unusual case of postoperative pseudoaneurysm of the left ventricle: Doppler echocardiographic findings. Journal of the American College of Cardiology 1986. link80203-0) 24 Ryan T, Petrovic O, Armstrong WF, Dillon JC, Feigenbaum H. Quantitative two-dimensional echocardiographic assessment of patients undergoing left ventricular aneurysmectomy. American heart journal 1986. link90105-5) 25 Visser CA, Kan G, Meltzer RS, Moulijn AC, David GK, Dunning AJ. Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography. The American journal of cardiology 1985. link90769-6) 26 Lumia FJ, Makam S, MacMillan RM, Germon PA, Maranhao V, Strong MD. Left ventricular function after elective aneurysmectomy. Clinical cardiology 1985. link 27 Ormerod OJ, Barber RW, Stone DL, Taylor NC, Wraight EP, Petch MC. Improved selection of patients for aneurysmectomy by combined phase and amplitude analysis of gated cardiac scintigraphy. European heart journal 1985. link 28 Foster CJ, Sekiya T, Brownlee WC, Griffin JF, Isherwood I. Computed tomographic assessment of left ventricular aneurysms. British heart journal 1984. link 29 Paolillo V, Viglione G, Baduini G, Dor V, Angelino PF. Chronic intrapericardial bleeding from a left ventricular aneurysm. European heart journal 1983. link 30 Ezekowitz MD, Wilson DA, Smith EO, Burow RD, Harrison LH, Parker DE et al.. Comparison of Indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi. The New England journal of medicine 1982. link 31 Erikson U, Hallén A, Helmius G, Sawada S. On the pathophysiology of left ventricular aneurysm. An analysis by cineangiography and videodensitometry. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 1982. link 32 Amon KW, Crawford MH. Improved two-dimensional echocardiographic technique for left ventricular aneurysm detection. Journal of clinical ultrasound : JCU 1982. link 33 Gewirtz H, Wilner A, Garriepy S, Ree HJ, Most AS. Diagnosis of left-ventricular mural thrombus by means of radionuclide ventriculography. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1981. link 34 Erlebacher JA, Becker LC, Weiss JL, Leitl GP, Achuff SC, Fortuin NJ. Clinical recognition of giant left ventricular aneurysm. The American journal of medicine 1981. link90367-3) 35 Majid PA, Wardeh R, De Feyter PJ, Roos JP. Left ventricular aneurysm: pre- and postoperative haemodynamic studies at rest and during exercise. European journal of cardiology 1981. link 36 Szarnicki RJ, De Leval MR, Stark J. Calcified left ventricular aneurysm in a 6-year-old Caucasian boy. British heart journal 1981. link 37 Reeder GS, Lengyel M, Tajik AJ, Seward JB, Smith HC, Danielson GK. Mural thrombus in left ventricular aneurysm: incidence, role of angiography, and relation between anticoagulation and embolization. Mayo Clinic proceedings 1981. link 38 Allen AP, Peart I, Taylor DN, Condon BR, Ogilvie BC, Frank JW et al.. Poor sensitivity of multiple-gated blood-pool imaging in diagnosing left ventricular aneurysms. British medical journal (Clinical research ed.) 1981. link 39 Catherwood E, Mintz GS, Kotler MN, Parry WR, Segal BL. Two-dimensional echocardiographic recognition of left ventricular pseudoaneurysm. Circulation 1980. link 40 Gatewood RP, Nanda NC. Differentiation of left ventricular pseudoaneurysm from true aneurysm with two dimensional echocardiography. The American journal of cardiology 1980. link90442-7) 41 Grondin P, Kretz JG, Bical O, Donzeau-Gouge P, Petitclerc R, Campeau L. Natural history of saccular aneurysms of the left ventricle. The Journal of thoracic and cardiovascular surgery 1979. link 42 Hickey AJ, Braye S. Annular subvalvular left ventricular aneurysm mimicking a pericardial effusion on echocardiogram. Australian and New Zealand journal of medicine 1979. link 43 Lukács L, Lónyai T. Successful repair of left ventricular aneurysm due to blunt trauma. A case report. The Journal of cardiovascular surgery 1978. link 44 Hellman RM, Rufty AJ. Left ventricular aneurysms caused by blunt chest trauma. Southern medical journal 1978. link 45 Thadani U, Lynn RB, Parker JO. Submitral annular left ventricular aneurysm--unusual echocardiographic and angiographic features. Catheterization and cardiovascular diagnosis 1978. link 46 Johansson L, Michaëlsson M, Sjögren S. Congenital left ventricular apical aneurysm. Scandinavian journal of thoracic and cardiovascular surgery 1976. link 47 Lintermans JP. Calcified subvalvular left ventricular aneurysm: an unusual case in a 4-year-old-child. Pediatric radiology 1976. link 48 Botvinick EH, Shames D, Hutchinson JC, Roe BB, Fitzpatrick M. Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm. The American journal of cardiology 1976. link90430-6) 49 Kittredge RD, Gamboa B, Kemp HG. Radiographic visualization of left ventricular aneurysms on lateral chest film. AJR. American journal of roentgenology 1976. link 50 Sandiford FM, Cooley DA. Resection of left ventricular aneurysm. Report of 277 patients. Giornale italiano di cardiologia 1975. link 51 Greenwald J, Yap JF, Franklin M, Lichtman AM. Echocardiographic mitral systolic motion in left ventricular aneurysm. British heart journal 1975. link 52 Rigo P, Gach J, Mengeot PH. Pre- and postoperative myocardial and blood pool scans in a case of left ventricular aneurysm: Case report. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1975. link

    Original source

    1. [1]
      A Nomogram to Predict Patient Mortality After Linear Ventriculoplasty for Left Ventricular Aneurysm.Tiemuerniyazi X, Song Y, Chen L, Zhang S, Ma H, Nan Y et al. Heart, lung & circulation (2026)
    2. [2]
      The Pacopexy procedure for left ventricular aneurysm: a 10-year clinical experience.Cui H, Wu Y, Wei S, Gao C, Jiang S Surgery today (2020)
    3. [3]
      A variant "no-patch" technique for surgery of left ventricular aneurysms.Evora PR, Bassetto S, Junior LA Asian cardiovascular & thoracic annals (2014)
    4. [4]
      Left ventricular reconstruction with no-patch technique: early and late clinical outcomes.Hu SS, Fan HG, Zheng Z, Feng W, Wang W, Song YH et al. Chinese medical journal (2010)
    5. [5]
      A giant inferoposterior true aneurysm of the left ventricle mimicking a pseudoaneurysm.Yavuzgil O, Gürgün C, Apaydin A, Cinar CS, Yüksel A, Kültürsay H The international journal of cardiovascular imaging (2006)
    6. [6]
      99mTc-MIBI SPECT assessment of the effects of aneurysm resection on the left ventricular morphology.Koszegi Z, Kolozsvari R, Varga J, Galuska L, Szuk T, Csapo K et al. Acta cardiologica (2004)
    7. [7]
      Improved left ventricular aneurysm repair with bioengineered vascular smooth muscle grafts.Matsubayashi K, Fedak PW, Mickle DA, Weisel RD, Ozawa T, Li RK Circulation (2003)
    8. [8]
      Left ventricular thrombus capture by an intra-aortic filter device.Martens S, Dietrich M, Ozaslan F, Wimmer-Greinecker G, Moritz A The Thoracic and cardiovascular surgeon (2002)
    9. [9]
      Angiotensin-converting enzyme inhibitor helps prevent late remodeling after left ventricular aneurysm repair in rats.Nomoto T, Nishina T, Miwa S, Tsuneyoshi H, Maruyama I, Nishimura K et al. Circulation (2002)
    10. [10]
      Long term follow up of left ventricular function after repair of left ventricular aneurysm. A comparison of linear closure versus patch plasty.Doss M, Martens S, Sayour S, Hemmer W European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2001)
    11. [11]
      Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies.Qin JX, Jones M, Shiota T, Greenberg NL, Tsujino H, Firstenberg MS et al. Journal of the American College of Cardiology (2000)
    12. [12]
      Effect of aneurysmectomy on left ventricular shape and function: case studies.Petrank YF, Azhari H, Lessick J, Sideman S, Beyar R Medical engineering & physics (1999)
    13. [13]
      Calcified subaortic left ventricular aneurysm causing right pulmonary artery obstruction in a child.Mohan JC, Hygriv Rao B, Arora R, Nigam M International journal of cardiology (1998)
    14. [14]
    15. [15]
    16. [16]
      Endoventricular remodeling of left ventricular aneurysm. Functional, clinical, and electrophysiological results.Grossi EA, Chinitz LA, Galloway AC, Delianides J, Schwartz DS, McLoughlin DE et al. Circulation (1995)
    17. [17]
      Mechanical dysfunction in the border zone of an ovine model of left ventricular aneurysm.Moulton MJ, Downing SW, Creswell LL, Fishman DS, Amsterdam DM, Szabó BA et al. The Annals of thoracic surgery (1995)
    18. [18]
      Comparison of tomographic and planar radionuclide ventriculography in the assessment of regional left ventricular function in patients with left ventricular aneurysm before and after surgery.Lu P, Liu X, Shi R, Mo L, Borer JS Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (1994)
    19. [19]
      Repair of left ventricular aneurysm. Changes in ventricular mechanics, hemodynamics, and oxygen consumption.Savage EB, Downing SW, Ratcliffe MB, Fallert M, Gupta KB, Tyson GS et al. The Journal of thoracic and cardiovascular surgery (1992)
    20. [20]
      Thrombus within a submitral left ventricular aneurysm: diagnosis on cross sectional echocardiography.Lawson CS, Venn GE, Webb-Peploe MM British heart journal (1991)
    21. [21]
      Improved detection of anterior left ventricular aneurysm with multiharmonic fourier analysis.Valette HB, Bourguignon MH, Merlet P, Grégoire MC, Le Guludec D, Pascal O et al. Journal of nuclear medicine : official publication, Society of Nuclear Medicine (1990)
    22. [22]
      Impairment in right ventricular performance after left ventricular aneurysm surgery.Mangschau A, Geiran O, Rootwelt K, Laake B, Forfang K The Annals of thoracic surgery (1988)
    23. [23]
      An unusual case of postoperative pseudoaneurysm of the left ventricle: Doppler echocardiographic findings.Wang R, DeSantola JR, Reichek N, Edie R Journal of the American College of Cardiology (1986)
    24. [24]
      Quantitative two-dimensional echocardiographic assessment of patients undergoing left ventricular aneurysmectomy.Ryan T, Petrovic O, Armstrong WF, Dillon JC, Feigenbaum H American heart journal (1986)
    25. [25]
      Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography.Visser CA, Kan G, Meltzer RS, Moulijn AC, David GK, Dunning AJ The American journal of cardiology (1985)
    26. [26]
      Left ventricular function after elective aneurysmectomy.Lumia FJ, Makam S, MacMillan RM, Germon PA, Maranhao V, Strong MD Clinical cardiology (1985)
    27. [27]
      Improved selection of patients for aneurysmectomy by combined phase and amplitude analysis of gated cardiac scintigraphy.Ormerod OJ, Barber RW, Stone DL, Taylor NC, Wraight EP, Petch MC European heart journal (1985)
    28. [28]
      Computed tomographic assessment of left ventricular aneurysms.Foster CJ, Sekiya T, Brownlee WC, Griffin JF, Isherwood I British heart journal (1984)
    29. [29]
      Chronic intrapericardial bleeding from a left ventricular aneurysm.Paolillo V, Viglione G, Baduini G, Dor V, Angelino PF European heart journal (1983)
    30. [30]
      Comparison of Indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi.Ezekowitz MD, Wilson DA, Smith EO, Burow RD, Harrison LH, Parker DE et al. The New England journal of medicine (1982)
    31. [31]
      On the pathophysiology of left ventricular aneurysm. An analysis by cineangiography and videodensitometry.Erikson U, Hallén A, Helmius G, Sawada S RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (1982)
    32. [32]
      Improved two-dimensional echocardiographic technique for left ventricular aneurysm detection.Amon KW, Crawford MH Journal of clinical ultrasound : JCU (1982)
    33. [33]
      Diagnosis of left-ventricular mural thrombus by means of radionuclide ventriculography.Gewirtz H, Wilner A, Garriepy S, Ree HJ, Most AS Journal of nuclear medicine : official publication, Society of Nuclear Medicine (1981)
    34. [34]
      Clinical recognition of giant left ventricular aneurysm.Erlebacher JA, Becker LC, Weiss JL, Leitl GP, Achuff SC, Fortuin NJ The American journal of medicine (1981)
    35. [35]
      Left ventricular aneurysm: pre- and postoperative haemodynamic studies at rest and during exercise.Majid PA, Wardeh R, De Feyter PJ, Roos JP European journal of cardiology (1981)
    36. [36]
      Calcified left ventricular aneurysm in a 6-year-old Caucasian boy.Szarnicki RJ, De Leval MR, Stark J British heart journal (1981)
    37. [37]
      Mural thrombus in left ventricular aneurysm: incidence, role of angiography, and relation between anticoagulation and embolization.Reeder GS, Lengyel M, Tajik AJ, Seward JB, Smith HC, Danielson GK Mayo Clinic proceedings (1981)
    38. [38]
      Poor sensitivity of multiple-gated blood-pool imaging in diagnosing left ventricular aneurysms.Allen AP, Peart I, Taylor DN, Condon BR, Ogilvie BC, Frank JW et al. British medical journal (Clinical research ed.) (1981)
    39. [39]
      Two-dimensional echocardiographic recognition of left ventricular pseudoaneurysm.Catherwood E, Mintz GS, Kotler MN, Parry WR, Segal BL Circulation (1980)
    40. [40]
    41. [41]
      Natural history of saccular aneurysms of the left ventricle.Grondin P, Kretz JG, Bical O, Donzeau-Gouge P, Petitclerc R, Campeau L The Journal of thoracic and cardiovascular surgery (1979)
    42. [42]
      Annular subvalvular left ventricular aneurysm mimicking a pericardial effusion on echocardiogram.Hickey AJ, Braye S Australian and New Zealand journal of medicine (1979)
    43. [43]
      Successful repair of left ventricular aneurysm due to blunt trauma. A case report.Lukács L, Lónyai T The Journal of cardiovascular surgery (1978)
    44. [44]
      Left ventricular aneurysms caused by blunt chest trauma.Hellman RM, Rufty AJ Southern medical journal (1978)
    45. [45]
      Submitral annular left ventricular aneurysm--unusual echocardiographic and angiographic features.Thadani U, Lynn RB, Parker JO Catheterization and cardiovascular diagnosis (1978)
    46. [46]
      Congenital left ventricular apical aneurysm.Johansson L, Michaëlsson M, Sjögren S Scandinavian journal of thoracic and cardiovascular surgery (1976)
    47. [47]
    48. [48]
      Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm.Botvinick EH, Shames D, Hutchinson JC, Roe BB, Fitzpatrick M The American journal of cardiology (1976)
    49. [49]
      Radiographic visualization of left ventricular aneurysms on lateral chest film.Kittredge RD, Gamboa B, Kemp HG AJR. American journal of roentgenology (1976)
    50. [50]
      Resection of left ventricular aneurysm. Report of 277 patients.Sandiford FM, Cooley DA Giornale italiano di cardiologia (1975)
    51. [51]
      Echocardiographic mitral systolic motion in left ventricular aneurysm.Greenwald J, Yap JF, Franklin M, Lichtman AM British heart journal (1975)
    52. [52]
      Pre- and postoperative myocardial and blood pool scans in a case of left ventricular aneurysm: Case report.Rigo P, Gach J, Mengeot PH Journal of nuclear medicine : official publication, Society of Nuclear Medicine (1975)

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