A variant technique for the surgical treatment of left ventricular aneurysms.

Abstract

OBJECTIVE:

To present a surgical variant technique to repair left ventricular aneurysms.

METHODS:

After anesthesia, cardiopulmonary bypass, and myocardial protection with hyperkalemic tepic blood cardioplegia: 1) The left ventricle is opened through the infarct and an endocardial encircling suture is placed at the transitional zone between the scarred and normal tissue; 2) Next, the scar tissue is circumferentially plicated with deep stitches using the same suture thread, taking care to eliminate the entire septal scar; 3) Then, a second encircling suture is placed, completing the occlusion of the aneurysm, and; 4) Finally, the remaining scar tissue is oversewn with an invaginating suture, to ensure hemostasis. Myocardium revascularization is performed after correction of the left ventricle aneurysm. The same surgeon performed all the operations.

RESULTS:

Regarding the post-surgical outcome 4 patients (40%) had surgery 8 eight years ago, 2 patients (20%) were operated on over 6 years ago, and 1 patient (10%) was operated on more than 5 years ago. Three patients (30%) were in functional class I, class II in 2 patients (20%) and 2 patients (20%) with severe comorbidities remains in class III of the NYHA. There were three deaths (at four days, 15 days and eight months) in septuagenarians with acute myocardial infarction, diabetes and pulmonary emphysema.

CONCLUSION:

The technique is easy to perform, safe and it can be an option for the correction of left ventricle aneurysms.

• Authors: Paulo Roberto Barbosa Evora, Paulo Victor Alves Tubino, Luis Gustavo Gali, Lafaiete Alves Junior, Cesar Augusto Ferreira, Solange Bassetto, Antônio Carlos Menardi, Alfredo José Rodrigues, Walter Vilella de Andrade Vicente
• Journal: Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular (Rev Bras Cir Cardiovasc) 2014 Oct-Dec Vol. 29 Issue 4 Pg. 645-9 Brazil
• PMID: 25714220 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Cardiac Surgical Procedures (methods)
• Female
• Heart Aneurysm (diagnostic imaging, surgery)
• Heart Ventricles (diagnostic imaging, surgery)
• Humans
• Male
• Medical Illustration
• Middle Aged
• Myocardial Revascularization (methods)
• Reproducibility of Results
• Suture Techniques
• Time Factors
• Treatment Outcome
• Ultrasonography