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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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CASE REPORTS  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2003 December;44(6):741-44

lingua: Inglese

True acquired left ventricular aneurysms in childhood

Long M. A., Hough J., De Vries W. J.

Depart­ment of Car­di­oth­o­racic Sur­gery, Faculty of ­Health Sci­ences, Uni­ver­sity of the ­Orange ­Free ­State, Bloem­fontein, ­South ­Africa


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Aim. ­True ­left ven­tric­ular aneu­rysms are ­rarely encoun­tered in child­hood. Etio­log­ical fac­tors are ­varied and ­often inde­ter­min­able. ­There is a pau­city of lit­er­a­ture ­detailing the sur­gical tech­niques ­used to ­repair pedi­atric aneu­rysms.
­Methods. ­Three chil­dren ­aged 21 ­months, 19 ­months and 5 ­years ­with ­true ­left ven­tric­ular aneu­rysms under­went sur­gical ­repair in our ­unit. The clin­ical ­details, sur­gical tech­nique, his­to­log­ical ­review, hos­pital out­come and ­short ­term ­follow-up is dis­cussed.
­Results. Two ­patients under­went ­repair of ­their aneu­rysms by ­means of the ­Cooley endo­aneu­rys­mor­raphy tech­nique, and 1 ­patient under­went ­repair ­using the aneu­rysm resec­tion and ­linear pli­ca­tion tech­nique. His­to­log­ical exam­ina­tion ­revealed tuber­cu­losis to be the etio­log­ical ­factor in one ­patient, ­while a non-spe­cific vas­cu­litis was ­present in the ­other 2 ­patients. Imme­diate ­postoper­a­tive ­course was ­uneventful and all ­3 ­patients ­were dis­charged ­from hos­pital ­within one ­week. Two ­patients ­were recath­e­ter­ized ­during ­follow-up ­visits. All ­patients ­were asymp­to­matic at 1 ­year ­follow-up. Ech­o­car­di­og­raphy dem­on­strated ­good ­left ven­tric­ular func­tion ­with dis­ap­pear­ance of preoper­a­tive ­mitral regur­gi­ta­tion.
Con­clu­sion. Pedi­atric ­left ven­tric­ular aneu­rysms may be suc­cess­fully ­repaired ­using stan­dard oper­a­tive tech­niques. ­These tech­niques ­render excel­lent ­short-­term ­results. ­Longer ­follow-up is ­needed to ­fully eval­uate the out­come of ­these chil­dren.

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