On-Pump Beating Heart Endoventriculoplasty Using Autologous Endocardium for Left Ventricular Aneurysm Repair

Abstract

The operative goals of the repair of postinfarction left ventricular aneurysms are to correct the size and geometry of the left ventricle in order to reduce wall tension and paradoxical movement and to improve the systolic function. Endoventriculoplasty has become the gold standard, since the late 1980s when it was described by Jatene and modified by Dor et al. Endoventriculoplasty using autologous endocardium for left ventricular aneurysm was first described by Grandjean et al. We present here a case report of on-pump beating heart endoventriculoplasty using autologous endocardium for postinfarction left ventricular anterior aneurysm. This technique, as a modification of the Dor technique, restores the ventricular geometry without leaving any segment of non-contractile ventricular wall and avoids the usage of prosthetic materials. 

Keywords

• Left ventricular aneurysm,endoventriculoplasty,myocardial infarction complications

References

1. Antunes MJ, Antunes PE. Left ventricular aneurysms: from dis- ease to repair. Expert Rev Cardiovasc Ther 2005;3:285-94. [CrossRef]
2. Yu Y, Gu CX, Wei H, Liu R, Chen CC, Fang Y. Repair of left ventric- ular aneurysm during off-pump coronary artery bypass surgery. Chin Med J (Engl) 2005;118:1072-5.
3. Jatene AD. Left ventricular aneurysmectomy: resection or recon- struction. J Thorac Cardiovasc Surg 1985;89:321-31.
4. Dor V, Saab M, Coste P, Komaszewska M, Montiglio F. Left ven- tricular aneurysm: a new surgical approach. Thorac Cardiovasc Surg 1989;37:11-9. [CrossRef]
5. Grandjean JG, Mariani MA, D’Alfonso A, Musazzi A, Boonstra PW. Endoventriculoplasty using autologous endocardium for anterior left ventricular aneurysms. Thorac Cardiovasc Surg 2005;53:52-5. [CrossRef]
6. Raja SG, Salehi S, Bahrami TT. Impact of technique of left ventric- ular aneurysm repair on clinical outcomes: current best available evidence. J Card Surg 2009;24:319-24. [CrossRef]
7. Marchenko AV, Cherniavsky AM, Volokitina TL, Alsov SA, Karas- kov AM. Left ventricular dimension and shape after postinfarc- tion aneurysm repair. Eur J Cardiothorac Surg 2005;27:475-80. [CrossRef]
8. Di Mattia DG, Di Biasi P, Salati M, Mangini A, Fundaro P, Santoli C. Surgical treatment of left ventricular post-infarction aneurysm with endoventriculoplasty: late clinical and functional results. Eur J Cardiothorac Surg 1999;15:413-8. [CrossRef]

9. Vural KM, Sener E, Ozatik MA, Tasdemir O, Bayazit K. Left ven- tricular aneurysm repair: an assessment of surgical treatment mo- dalities. Eur J Cardiothorac Surg 1998;13:49-56. [CrossRef]
10. Sinatra R, Macrina F, Braccio M, Melina G, Luzi G, Ruvolo G, et al. Left ventricular aneurysmectomy; comparison between two techniques; early and late results. Eur J Cardiothorac Surg 1997;12:291-7. [CrossRef]
11. Frapier JM, Hubaut JJ, Pasquie JL, Chaptal PA. Large encircling cryoablation without mapping for ventricular tachycardia after anterior myocardial infarction: long-term outcome. J Thorac Car- diovasc Surg 1998;116:578-83. [CrossRef]
12. Bakker PFA, De Lange F, Hauer RNW, Derksen R, De Bakker JM. Sequential map-guided endocardial resection for ventricu- lar tachycardia improves outcome. Eur J Cardiothorac Surg 2001;19:448-54. [CrossRef]
13. Nath S, Haines DE, Kron IL, DiMarco JP. The long-term outcome of visually directed subendocardial resection in patients without inducible or mappable ventricular tachycardia at the time of sur- gery. J Cardiovasc Electrophysiol 1994;5:399-407. [CrossRef]
14. Dor V, Sabatier M, Montiglio F, Rossi P, Toso A, Di Donato M. Results of nonguided endocardiectomy associated with left ven- tricular reconstruction in patients with ischemic ventricular ar- rhythmias. J Thorac Cardiovasc Surg 1994;107:1301-8.
15. Wellens F, Geelen P, Demirsoy E, Van Praet F, De Geest R, De- grieck I, et al. Surgical treatment of tachyarrhythmias due to postinfarction left ventricular aneurysm with endoaneurysmor- rhaphy and cryoablation. Eur J Cardiothorac Surg 2002;22:771-6. [CrossRef]