A variant technique for the surgical treatment of left ventricular aneurysms

Revista Brasileira de Cirurgia Cardiovascular

Paulo Roberto Barbosa Evora¹  Paulo Victor Alves Tubino¹  Luis Gustavo Gali¹  Lafaiete Alves Junior¹  Cesar Augusto Ferreira¹  Solange Bassetto¹  Antônio Carlos Menardi¹  Alfredo José Rodrigues¹  Walter Vilella De Andrade Vicente¹ 

关键词: Left ventricle aneurysm;    Left ventricle aneurysmectomy;    Ischemic heart disease;    Thoracic surgery;    Aneurisma do ventrículo esquerdo;    Aneurismectomia do ventrículo esquerdo;    Doença isquêmica do coração;    Cirurgia torácica;   

DOI  :  10.5935/1678-9741.20140110

来源: SciELO

【 摘 要 】

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.

【 授权许可】

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