초록접수 현황
| 16F-299 | Video session발표 |
Surgical Ventricular Restoration in Patient with Large Anterior Left Ventricular Aneurysm
Sang-Ho Cho¹, Dae Hyun Kim¹, Young Tae Kwak¹, Joo-Chul Park¹, Hyo Chul Yoon², Soo-Cheol Kim², Bum-Sik Kim²
¹Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea, ²Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
Background : The aneurysm of left ventricle (LV) most commonly the result of myocardial infarction (MI), usually involving anterior wall resulting in the out-pouching of thinned and scarred myocardium which becomes dyskinetic in systole. We report a case of surgical ventricular restoration in patient with progressive large anterior LV aneurysm.
Methods : A 77 year-old woman who had undergone coronary stent implantation at proximal LAD 30 months ago presented with a progressive large LV aneurysm. Chest X-ray, CT scan, and echocardiography showed a very large aneurysmal dilatation of the anterior LV not containing any thrombus. The aneurysm arose from the anterior wall of the mid cavity of the LV and the aneurysm itself measured 66 x 66 x 55 mm. The LV was not dilated except for the aneurysmal lesion. Coronary angiography showed no significant obstructive lesion and a patent LAD stent.
Results : The patient underwent left ventricular aneurysmectomy. With the heart arrested, the LV aneurysm was dissected and opened. Thin and laminated thrombi along the aneurysmal internal wall were removed. The margin of the aneurysm was demarcated and two circumferential endoventricular (Fontan) circular sutures around a balloon were passed to measure the size of LV to a diastolic volume of 50ml/㎡. The residual defect was closed with Dacron graft, and then the ventriculotomy was closed with two-layered 2-0 Prolene reinforced by Teflon strips. The postoperative course was uneventful and She was discharged from the hospital on postoperative day 11 with no neurological or cardiovascular sequelae.
Conclusion : The aim of surgical therapy for large LV aneurysm is restoration of LV geometry, LV volume reduction, and the relief of ischemia by CABG in the presence of concomitant coronary artery disease in viable myocardial territory. We report a case of surgical ventricular restoration in patient with progressive large anterior LV aneurysm.
Methods : A 77 year-old woman who had undergone coronary stent implantation at proximal LAD 30 months ago presented with a progressive large LV aneurysm. Chest X-ray, CT scan, and echocardiography showed a very large aneurysmal dilatation of the anterior LV not containing any thrombus. The aneurysm arose from the anterior wall of the mid cavity of the LV and the aneurysm itself measured 66 x 66 x 55 mm. The LV was not dilated except for the aneurysmal lesion. Coronary angiography showed no significant obstructive lesion and a patent LAD stent.
Results : The patient underwent left ventricular aneurysmectomy. With the heart arrested, the LV aneurysm was dissected and opened. Thin and laminated thrombi along the aneurysmal internal wall were removed. The margin of the aneurysm was demarcated and two circumferential endoventricular (Fontan) circular sutures around a balloon were passed to measure the size of LV to a diastolic volume of 50ml/㎡. The residual defect was closed with Dacron graft, and then the ventriculotomy was closed with two-layered 2-0 Prolene reinforced by Teflon strips. The postoperative course was uneventful and She was discharged from the hospital on postoperative day 11 with no neurological or cardiovascular sequelae.
Conclusion : The aim of surgical therapy for large LV aneurysm is restoration of LV geometry, LV volume reduction, and the relief of ischemia by CABG in the presence of concomitant coronary artery disease in viable myocardial territory. We report a case of surgical ventricular restoration in patient with progressive large anterior LV aneurysm.
책임저자: Sang-Ho Cho
Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
발표자: Sang-Ho Cho, E-mail : sinan75@khnmc.or.kr