Left ventricle remodelling by double-patch sandwich technique.

Area of Science:

• Cardiovascular Surgery
• Cardiac Reconstruction
• Myocardial Repair

Background:

• The sandwich double-patch technique offers an alternative for left ventricle reconstruction after postinfarction dysfunctional myocardium excision.
• Addresses technical challenges posed by thick ventricular wall edges encountered in such procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of the sandwich double-patch technique for left ventricular aneurysm repair.
• To assess the impact of this technique on ventricular volumes, ejection fraction, and patient outcomes.

Main Methods:

• Applied the sandwich double-patch technique to 12 patients with postinfarction antero-apical left ventricular aneurysms over a 5-year period.
• The ventricular opening was secured between two smaller patches, sutured with a single row of stitches, effectively narrowing the cavity and closing the ventricle.

Main Results:

• Significant improvements observed in left ventricular volumes and ejection fraction (p < 0.001).
• All patients experienced symptom-free recovery, with NYHA class improving from 2.5 to 1.2 (p < 0.001).
• Low morbidity with a mean postoperative hospital stay of 10.5 days.

Conclusions:

• The double-patch sandwich technique (bi-patch closure) provides advantages for left ventricular aneurysm excision.
• This method simplifies the repair process by avoiding complex suturing techniques required for linear closure or endoventricular patch repair.
• The technique demonstrates acceptable morbidity and mortality, offering a safe and effective reconstructive option.