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Left ventricular aneurysms associated with intraoperative venting of the cardiac apex in children
Insights
Left ventricular apical aneurysms occurred in 32% of children after heart surgery. These aneurysms, though asymptomatic, may pose future cardiovascular risks.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Medical Imaging
Background:
- Congenital heart disease often requires surgical intervention.
- Surgical repair may involve cardiopulmonary bypass with left ventricular apex venting.
- The long-term effects of specific venting methods require investigation.
Observation:
- Left ventricular (LV) apical aneurysms were identified in 32% of pediatric patients post-surgery.
- Aneurysms were generally small, with average dimensions noted.
- LV apical wall was thinner in patients with aneurysms compared to controls.
Findings:
- A significant incidence of LV apical aneurysms was observed after surgical repair of congenital heart disease.
- Patients with aneurysms remained asymptomatic during a 4-year follow-up period.
- Thinner apical walls suggest a potential structural vulnerability.
Implications:
- LV apical aneurysms may represent a latent risk for future cardiovascular complications.
- Alternative methods for left ventricular venting during surgery should be considered.
- Further research is warranted to understand the natural history and management of these aneurysms.
Abstract:
Left ventricular (LV) apical aneurysms were observed in 16 of 50 (32%) children (average age 8 years) consecutively catheterized after surgical repair of congenital heart disease. The LV apex was vented by a sump during cardiopulmonary bypass in each. The aneurysms varied in size, but were generally small. Average dimensions were 7.5 X 6.8 mm in the anteroposterior projection and 8.9 X 5.7 mm in the left anterior oblique projection. The LV apex wall was thinner in patients with aneurysms than in age- and lesion-matched controls. All of the LV aneurysm patients were asymptomatic during average follow-up of 4 years. Nevertheless, such aneurysms are anticipated to represent a potential source of cardiovascular complications and, when possible, alternate methods for venting the left ventricle are recommended.