[Endoventricular Stepwise Plication for Left Ventricular Aneurysm].

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Devices

Background:

• Left ventricular (LV) aneurysm is a serious condition often associated with heart failure and thromboembolic events.
• Surgical intervention for LV aneurysm aims to remove thrombus and restore normal cardiac geometry and function.
• Traditional surgical approaches may have limitations in achieving optimal LV reconstruction.

Observation:

• A 69-year-old male patient presented with a left ventricular aneurysm and mobile thrombus, despite oral anticoagulation.
• Echocardiography revealed significant LV dilation (LVEDVI 76 ml/m2, LVESVI 44 ml/m2) and apical dyskinesis.
• Surgical intervention involved opening the LV apex, removing the thrombus, and reconstructing the ventricle with a neo-apex using circular suturing.

Findings:

• The surgical procedure successfully removed the LV thrombus and reconstructed the LV apex.
• Postoperative echocardiography demonstrated a normalized LV shape with reduced volumes (LVEDVI 62 ml/m2, LVESVI 27 ml/m2).
• The patient experienced improved LV function following the neo-apex reconstruction.

Implications:

• This surgical technique offers a promising method for treating LV aneurysms with apical thrombus.
• LV reconstruction using a neo-apex may improve cardiac function and reduce the risk of future embolic events.
• Further studies are warranted to evaluate the long-term efficacy and broader applicability of this surgical approach.