{
  "abstract": "A woman in her early 50s presented to our centre 1 year back with a history of intermittent rest angina. ECG showed T inversions in V4–V6, I, AvL with normal left ventricular (LV) systolic function. She was diagnosed to have unstable angina in view of normal serum troponin levels and underwent a coronary angiogram which revealed significant left main and double vessel disease. She subsequently successfully underwent coronary artery bypass grafting surgery during the same admission with two grafts; left internal mammary artery (LIMA) to left anterior descending artery (LAD) and saphenous venous graft (SVG) to obtuse marginal (OM). She had been doing well since the surgery and remained asymptomatic. During a routine outpatient follow-up 12 months after the surgery, the ECG showed no interval changes; however, transthoracic echocardiography revealed the presence of an LV pseudoaneurysm measuring 5.4×3.1 cm along the posterolateral free wall of the LV with a neck measuring 2.3 cm. ( online supplemental file 1) LV function remained adequate with an ejection fraction of 58% as measured using modified Simpson’s method. On retrospective interrogation, the patient denied any history of chest discomfort or breathlessness. Blood pressure was 126/80 mm Hg, and the pulse rate was 76 beats/min and regular. A CT coronary angiogram was done which showed a patent LIMA to LAD graft but an occluded SVG to OM graft. It also confirmed the presence of the LV pseudoaneurysm free from presence of a thrombus.(figure 1)",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"
      ],
      "name": "Sadhanandham Shanmugasundaram"
    },
    {
      "affiliations": [
        "Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"
      ],
      "name": "Ramesh Sankaran"
    },
    {
      "affiliations": [
        "Kauvery Hospital, Chennai, Tamil Nadu, India"
      ],
      "name": "Manokar Panchanatham"
    },
    {
      "affiliations": [
        "Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"
      ],
      "name": "Judah Nijas Arul"
    }
  ],
  "title": "Delayed onset asymptomatic LV pseudoaneurysm occurring after coronary artery bypass grafting (CABG) surgery",
  "uid": "e1b19f46-2ca2-5175-8a84-58d6b32acdce"
}