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case_images: Twelve-lead electrocardiography at presentation. A 12-lead electrocardiogram shows ST elevation in inferior leads (II, III, AVF) with reciprocal ST depressions in lateral leads (I, AVL, V4-V6).
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case_images: Electrocardiogram demonstrated ST-segment elevations in the inferior leads (Figure 1).
case_images: Angiography of right coronary artery (RCA) in left anterior oblique projection. It demonstrates complete occlusion of the mid vessel with the reconstitution of distal RCA from right to right collaterals.
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case_images: He then underwent emergent coronary angiography, which divulged severe multi-vessel coronary artery disease, with complete occlusion of mid-right coronary artery (Figure 2; Supplementary Videos 1 and 2, available online).
case_images: Left ventriculogram. Left ventriculogram in anterior oblique (RAO) projection demonstrating an inferobasal wall true aneurysm.
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case_images: Left ventriculography revealed inferior wall hypokinesis of left ventricle with basilar inferior segment aneurysm and mural thrombus (Figure 3; Supplementary Video 3, available online).
case_images: Cardiac magnetic resonance (CMR) imaging. CMR imaging in sagittal view (2-chamber view) demonstrating left ventricular true aneurysm.
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case_images: It showed a wide-mouthed aneurysm in the base of the inferior wall, measuring 5.2 x 5.3 x 4.4 cm with an associated mural thrombus (Figure 4).
case_images: Cardiac magnetic resonance (CMR) imaging. Short-axis view of heart on CMR imaging showing ventricular septal rupture at inferobasal left ventricle.
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case_images: Table 2). Transmural delayed enhancement, involving mid and basal inferior septum, was suggestive of nonviable myocardium (Figure 5).
case_images: The step-wise approach to the aneurysmectomy procedure. LVA, left ventricular aneurysm; PP, polypropylene; IVMS, interrupted vertical mattress sutures; IMS, interrupted mattress sutures.
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case_images: The step-wise approach to the aneurysmectomy procedure is outlined in the flowchart (Figure 6).