Post-Myocardial Infarction Left Ventricular Pseudoaneurysm: A Meta-Analysis

Left ventricular pseudoaneurysm (LVPA) is a rare complication of myocardial infarction. The clinical characteristics and treatment of choice in the current era remain to be elaborated. The present article aims to give an overview of post-infarct LVPA and discuss the management strategy and outcomes. The study was based on comprehensive retrieval of literature of the recent 10 years. Myocardial infarctions as the underlying causes of LVPAs were mostly acute myocardial infarctions. The mean time for LVPA formation was 51.7 months after myocardial infarction. Postoperative and follow-up ejection fraction values were significantly higher than preoperative. In the interventional group patients, the oversize ratio of patients in whom devices remained in position was a little larger than that of those with a migrated one, but lack of a statistical significance (1.32±0.25 vs. 1.25±0.21, p=0.707). The mortality rate was significantly higher in the conservative group than in the surgical and interventional groups. Post-infarct LVPAs are curable to surgical aneurysmectomy and left ventricular reconstruction, thereby avoiding unexpected LVPA ruptures and other fatal complications. Elderly patients and patients at a high operative risk may resort to interventional therapy. The conservatively treated patients inevitably carry a considerable risk of death. An oversize ration of >1.3 might be a reference value for preventing device migration in the interventional group patients.