[HSF] When is an aneurysm pseudo?

[Tea Acuff]

Active readers of HSF may remember a discussion of an echo showing a posterior LV aneurysm amonth or so ago. I commented that I was concerned that it might be a pseudoaneurysm due to the marked concavity of the aneurysm. Dr. Frater pointed out there was no neck and it had a classic look of one of the many eponyms that I can never recall. So it had to be a true aneurysm. Someone was going to operate on it in the near future or already has by now without comment.

I recently came across a similar echo (as I am sure have others of you) showing the same thing. However this aneurysm was an early postop complication of post infarction CABG/MVR and at reoperation the LVA had no true wall, a wide "neck", and was thus pseudo in classification, but really a threat in vivo. This may be the only time I will be correct when I disagree with Dr. Frater, but clearly it will not be the last time that I question even his position although it makes me feel ignorant everytime. All classifications of real phenomena have fuzzy borders (as do their recognition as in this case), which is where the next understanding begins.

This example should be credited to JB Choi and others in the THI Journal 2006 (page 529). 

If the previous echo on HSF could be posted by its author with the operative findings, it would be informative for all of us.
 
tea