Reconstruction of the left ventricle after previous aneurysmectomy

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.