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Ann Thorac Surg 2006;81:1495-1497
© 2006 The Society of Thoracic Surgeons

Case report

Reconstruction of the Left Ventricle After Previous Aneurysmectomy

Arjun D. Koch, MDa, Eduard R. Holman, MDb, Michel I.M. Versteegh, MDa, Robert J.M. Klautz, MD, PhDa, Suresh T. Somer, MDb, Jeroen J. Bax, MD, PhDb, Robert A.E. Dion, MD, PhDa,*

a Department of Cardiothoracic Surgery Leiden, the Netherlands
b Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

Accepted for publication April 25, 2005.

* Address correspondence to Dr Dion, LUMC, Department of Cardio-thoracic Surgery, Albinusdreef 2, PO Box 9600, Leiden, 2300 RC, the Netherlands (Email: r.a.e.dion{at}lumc.nl).

Two patients recently underwent successful repeat left ventricular anterior aneurysmectomies at our institution. Both patients had undergone a linear repair at first operation. Over time severe heart failure relapsed and echocardiography revealed the recurrence of a voluminous antero-septo-apical aneurysm in both cases, associated with severe mitral regurgitation. Because of still preserved motion of at least three of the basal segments of the left ventricle, a repeat ventriculoplasty according to Dor and a restrictive mitral valve annuloplasty was attempted. At 6-month follow-up, the patients were in the New York Heart Association functional class I and II, respectively. Left ventricular end-diastolic diameters decreased from 73 mm to 67 mm and from 81 mm to 52 mm, and left ventricular end-systolic diameters from 61 mm to 54 mm and from 70 mm to 34 mm. Mitral regurgitation was absent.






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