LEFT VENTRICLE - Resected ventricular aneurysm

A hollow hemisphere, irregularly roughened on the convex surface where an occasional fleck of calcification can be seen in a fibrous tag, which was presumably adherent to the pericardium. The lesion has been incised and resutured, presumably to facilitate removal. On the concavity of the hemisphere there are several small areas of organising clot, and other areas where there are nodular excrescences of calcification
This man had a long history of ischaemic heart disease which latterly had presented with recurrent and refractory ventricular tachycardia. On his final admission the tachycardia did not respond to treatment and, as an emergency, a coronary bypass was done and the aneurysm was excised. He did not survive the operation. At autopsy the heart weighed 650g and showed marked left ventricular hypertrophy. There was also an abdominal aortic aneurysm measuring 15 x 10cm. Microscopy of the excised left ventricular aneurysm showed hyaline collagen, with areas of calcification and only an occasional fragment of residualcardiac muscle.