{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:56:53Z","timestamp":1785430613670,"version":"3.56.0"},"reference-count":14,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"},{"id":[{"id":"https:\/\/ror.org\/031d5vw30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Rapid, disproportionate expansion of post-infarction left ventricular (LV) aneurysms represents a high-risk remodeling phenotype characterized by progressive mechanical deterioration and severe geometric distortion. Methods: A 54-year-old male presented with late anterior myocardial infarction complicated by a partially thrombosed apical LV aneurysm with an initial left ventricular ejection fraction (LVEF) of 35%. Despite clinical stability under optimal guideline-directed medical therapy, serial multimodality imaging at 7 weeks revealed an aggressive, disproportionate expansion of the aneurysmal component to 120 mL, inducing severe ventricular geometric distortion and secondary functional degradation (LVEF 20%). Multimodality imaging demonstrated a favorable geometry of the functional ventricle with preserved contractile function. Results: The patient underwent prompt surgical ventricular restoration using a double-patch Dor technique, effectively excluding the large aneurysm and restoring physiological ventricular geometry. The postoperative course was uneventful. At 6-month follow-up, cardiovascular magnetic resonance confirmed sustained reverse remodeling and significant recovery of systolic LV function (LVEF 47%). Conclusions: This case illustrates that rapid post-infarction aneurysmal expansion may occur despite apparent clinical stability. Comprehensive multimodality imaging may help identify selected patients in whom a reconstructible myocardial substrate supports surgical ventricular restoration despite severely reduced LVEF, even when conventional clinical indications for aneurysmectomy are absent.<\/jats:p>","DOI":"10.3390\/jcm15145516","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:05:58Z","timestamp":1784077558000},"page":"5516","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapidly Progressive Post-Infarction Left Ventricular Aneurysm: Multimodality Imaging-Guided Assessment of Adverse Remodeling and Surgical Ventricular Restoration"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5743-3767","authenticated-orcid":false,"given":"Alina","family":"Craciun-Mirescu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Emergency County Clinical Hospital, 200642 Craiova, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4170-0356","authenticated-orcid":false,"given":"Oana","family":"Munteanu Mirea","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency County Clinical Hospital, 200642 Craiova, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-216X","authenticated-orcid":false,"given":"Despina Emanuela","family":"Toader","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency County Clinical Hospital, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denisa","family":"Epingeac","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency County Clinical Hospital, 200642 Craiova, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Militaru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency County Clinical Hospital, 200642 Craiova, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Raicea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiovascular Surgery, Emergency County Clinical Hospital, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1161\/01.CIR.81.4.1161","article-title":"Ventricular Remodeling after Myocardial Infarction. Experimental Observations and Clinical Implications","volume":"81","author":"Pfeffer","year":"1990","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jcmg.2010.10.008","article-title":"Left Ventricular Remodeling in Heart Failure","volume":"4","author":"Konstam","year":"2011","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1067\/mtc.2002.122439","article-title":"Basic Science Review: The Helix and the Heart","volume":"124","author":"Buckberg","year":"2002","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1056\/NEJMoa0900559","article-title":"Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction","volume":"360","author":"Jones","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.jtcvs.2022.04.016","article-title":"Long-Term Results of Surgical Ventricular Reconstruction and Comparison with the Surgical Treatment for Ischemic Heart Failure Trial","volume":"167","author":"Gaudino","year":"2024","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.athoracsur.2008.10.071","article-title":"Surgical Ventricular Restoration: Left Ventricular Shape Influence on Cardiac Function, Clinical Status, and Survival","volume":"87","author":"Castelvecchio","year":"2009","journal-title":"Ann. Thorac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12968-020-00607-1","article-title":"Standardized Cardiovascular Magnetic Resonance Imaging (CMR) Protocols: 2020 Update","volume":"22","author":"Kramer","year":"2020","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jcct.2014.07.003","article-title":"SCCT Guidelines for the Interpretation and Reporting of Coronary CT Angiography: A Report of the Society of Cardiovascular Computed Tomography Guidelines Committee","volume":"8","author":"Leipsic","year":"2014","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jacc.2008.03.041","article-title":"Detection of Left Ventricular Thrombus by Delayed-Enhancement Cardiovascular Magnetic Resonance","volume":"52","author":"Weinsaft","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1053\/stcs.2001.29966","article-title":"Left Ventricular Reconstruction by Endoventricular Circular Patch Plasty Repair: A 17-Year Experience","volume":"13","author":"Dor","year":"2001","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.jacc.2004.07.017","article-title":"Surgical Ventricular Restoration in the Treatment of Congestive Heart Failure Due to Post-Infarction Ventricular Dilation","volume":"44","author":"Athanasuleas","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1001\/jamacardio.2018.1086","article-title":"Left Ventricular Thrombus After Acute Myocardial Infarction: Screening, Prevention, and Treatment","volume":"3","author":"McCarthy","year":"2018","journal-title":"JAMA Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5516\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:19:00Z","timestamp":1784078340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":14,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15145516"],"URL":"https:\/\/doi.org\/10.3390\/jcm15145516","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]}}}