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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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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