Left Ventricular Aneurysm Repair Through the Left Anterior Minithoracotomy

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Thoracic Surgery

Background:

• Left ventricular aneurysms (LVAs) are serious post-infarction complications.
• Traditional surgical repair often involves sternotomy, which can lead to longer recovery times.
• Minimally invasive approaches are increasingly sought for cardiac procedures.

Purpose of the Study:

• To detail the surgical technique for left ventricular aneurysm (LVA) repair.
• To evaluate the outcomes of LVA repair performed via left anterior thoracotomy.
• To assess the feasibility of combining LVA repair with coronary artery bypass grafting (CABG) and/or mitral valve (MV) surgery.

Main Methods:

• A cohort of 40 patients with postinfarction LVA underwent repair via left anterior thoracotomy.
• Simultaneous procedures included CABG (100%) and MV surgery (37.5%).
• The technique involved peripheral cardiopulmonary bypass, minithoracotomy, aortic cross-clamping, and cold blood cardioplegia.

Main Results:

• Successful LVA repair and complete revascularization were achieved in all patients without conversion to sternotomy.
• Mean cardiopulmonary bypass and cross-clamp times were 207 and 115.5 minutes, respectively.
• Low complication rates were observed, with an average ICU stay of 2.1 days and no strokes or hospital mortality (1 patient with 30-day mortality).

Conclusions:

• Left ventricular aneurysm repair, including combined procedures, via left anterior thoracotomy is an efficient and safe surgical approach.
• This minimally invasive technique offers a viable alternative to sternotomy for LVA management.
• The study demonstrates favorable short-term outcomes for this procedure.