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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2002 December;43(6):833-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Posterior non-ischemic left ventricular aneurysm. Report of 2 surgical cases

Lioulias A. G., Kokotsakis J. N., Skouteli E. A. T., Boulafendis D. G.

Department of Cardiovascular Surgery Spring Branch Medical Center Houston, Texas, USA


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Posterior ­non-ischem­ic ­left ven­tric­u­lar aneu­rysms ­are unusu­al aneu­rysms of dif­fer­ent eti­ol­o­gy ­that devel­op adja­cent to ­the ­mitral ­valve annu­lus caus­ing ­mitral regur­gi­ta­tion ­and pro­gres­sive ­heart fail­ure. Surgical cor­rec­tion is man­da­to­ry ­and ­involves ­repair of ­the aneu­rysm ­along ­with ­repair or replace­ment of ­the ­mitral ­valve. Two cas­es of pos­te­ri­or ­non-ischem­ic ­left ven­tric­u­lar aneu­rysms ­are report­ed. Both ­patients ­were ­females (19 ­and 9 ­years ­old) ­and ­they pre­sent­ed ­with symp­toms of pro­gres­sive ­heart fail­ure. Definite diag­no­sis ­was ­made ­with tran­se­soph­a­geal ech­o­car­di­og­ra­phy (­TEE) ­and con­firmed ­with ­left ven­tric­u­log­ra­phy. Both ­patients ­were suc­cess­ful­ly treat­ed by sur­gery. The ­first ­patient under­went ­repair of ­the aneu­rysm ­from ­inside ­the ­left ven­tri­cle ­and ­mitral ­valve replace­ment. The sec­ond ­patient ­had resec­tion of ­the aneu­rysm ­through an extra­car­diac ­route. Both ­patients ­are in ­NYHA ­class 1, 5 ­and 4 ­years respec­tive­ly ­after ­their oper­a­tion ­with no evi­dence of ­mitral ­valve dys­func­tion. Posterior ­non-ischem­ic ­left ven­tric­u­lar aneu­rysms ­can secure­ly be diag­nosed by ­TEE ­and angio­car­di­og­ra­phy. Surgical treat­ment is man­da­to­ry in ­order to fore­stall poten­tial ­life threat­en­ing car­di­o­vas­cu­lar ­events ­and ­should be tail­ored to ­the oper­a­tive find­ings.

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