Left ventricular aneurysm in the scope of gated perfusion SPECT: accuracy of detection and ejection fraction calculation

Backgound: The development of resolution recovery (RR) algorithms has made it possible to preserve good quality of cardiac images in spite of reduced number of counts during study acquisition. Objective: Our purpose was to evaluate the performance of three different software packages in the quantification of left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) from gated perfusion SPECT, applying a resolution recovery (RR) algorithm (GE Myovation Evolution), respect to cardiac MRI (cMRI) as gold standard. Methods: We retrospectively enrolled 21 patients, with suspected or known coronary heart disease. Images at rest were reconstructed by filtered back projection (FBP) and by an iterative protocol with the RR algorithm. EDV, ESV and LVEF were automatically computed employing Quantitative gated SPECT (QGS), Myometrix (MX) and Corridor 4DM (4DM). Any difference in EDV, ESV and LVEF calculation between cMRI and the three packages (with FBP and iterative reconstruction with RR) was tested using Wilcoxon or paired t-test, with assumption of normality assessed using ShapiroWilk test. Agreement between imaging reconstruction algorithms and between gated-SPECT software packages and cMRI was studied with Pearson’s (r) or Spearman’s (R) correlation coefficients and Lin’s concordance correlation coefficient (LCC). Results: Intra-software evaluation always revealed very strong correlation coefficients (R, r ≥ 0.8) and excellent LCC coefficients (LCC > 0.95), except for LCC coefficient between MX-FBP and MX-RR in EDV evaluation, nevertheless considered very good (LCC = 0.94). EDV and ESV had significantly lower value when calculated with RR algorithm respect to FBP reconstruction in QGS and MX. LVEF estimation did not show significant differences for QGSFBP, QGS-RR, MX and 4DM-RR with respect to cMRI. Results: Intra-software evaluation always revealed very strong correlation coefficients (R, r ≥ 0.8) and excellent LCC coefficients (LCC > 0.95), except for LCC coefficient between MX-FBP and MX-RR in EDV evaluation, nevertheless considered very good (LCC = 0.94). EDV and ESV had significantly lower value when calculated with RR algorithm respect to FBP reconstruction in QGS and MX. LVEF estimation did not show significant differences for QGSFBP, QGS-RR, MX and 4DM-RR with respect to cMRI. Conclusion: All reconstruction methods sistematically understimate EDV and ESV, with higher underestimation applying only the RR. No significant differences were observed between 4DM -RR and 4DM-FBP, for each parameter, when 4DM package was used.

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Left Ventricular Aneurysm Repair with Use of a Bovine Pericardial Patch

Texas Heart Institute Journal ◽

10.14503/thij-13-3726 ◽

2014 ◽

Vol 41 (4) ◽

pp. 407-410 ◽

Cited By ~ 2

Author(s):

Matthew J. Henry ◽

Ourania Preventza ◽

Denton A. Cooley ◽

Kim I. de la Cruz ◽

Joseph S. Coselli

Keyword(s):

Myocardial Infarction ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Left Ventricular Aneurysm ◽

Pericardial Patch ◽

Ventricular Aneurysm ◽

Ventricular Ejection Fraction ◽

Bovine Pericardial Patch

Left ventricular aneurysm, which can impair systolic function, has a reported incidence of 10% to 35% in patients after myocardial infarction. In a 58-year-old woman who had a history of myocardial infarction, we excised a large left ventricular aneurysm and restored left ventricular geometry with use of a bovine pericardial patch. The aneurysm's characteristics and the patient's preoperative left ventricular ejection fraction of 0.25 had indicated surgical intervention. The patient had an uneventful postoperative course, and her left ventricular ejection fraction was 0.50 to 0.55 on the 4th postoperative day. This case illustrates the value of surgical treatment for patients who have a debilitating left ventricular aneurysm.

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The Successful Surgical Treatment of a Giant True Left Ventricular Aneurysm: a Case Report

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2018-7-4-372-377 ◽

2019 ◽

Vol 7 (4) ◽

pp. 372-377

Author(s):

Y. B. Brand ◽

M. K. Mazanov ◽

E. N. Ostroumov ◽

M. A. Sagirov ◽

N. I. Kharitonova ◽

...

Keyword(s):

Coronary Artery ◽

Surgical Treatment ◽

Left Ventricle ◽

Ejection Fraction ◽

Contractile Function ◽

Left Ventricular ◽

Left Ventricular Cavity ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Thrombosed Aneurysm

We report the successful surgical treatment of a giant true thrombosed aneurysm of the left ventricle.A 59-year-old male patient Z. was admitted with severe heart failure and chronic thrombosed aneurysm of the left ventricle, formed after acute extensive myocardial infarction, despite successful installation of a stent into the anterior descending artery in the acute period. Echocardiography revealed a significant increase in the volume of the left ventricular cavity, a significant decrease in the contractile function of the left ventricular myocardium (ejection fraction 32-36%), a giant left ventricular aneurysm (9x6 cm) with a parietal lining thrombus in the aneurysm cavity. Coronary angiography showed an aneurysmal dilatation of the circumflex branch of more than 6 mm, hemodynamically significant stenosis of two coronary arteries. According to the scintigraphy, the myocardium beyond the scar tissue was viable. The patient underwent resection of a left ventricular aneurysm, endoventricular plasty (Dor procedure), coronary artery bypass surgery of the circumflex artery and obtuse marginal branch of the left coronary artery.The patient was discharged in satisfactory condition on day 14 after surgery. At follow-up 6 months after surgery, an increase in the ejection fraction to 3941% was noted.

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Long-term results of treatment of left ventricular aneurysm of type II–III according to L. Menicanti and ejection fraction of less than 30%

Clinical and Experimental Surgery. Petrovsky journal ◽

10.33029/2308-1198-2020-8-2-37-44 ◽

2020 ◽

Vol 8 (2) ◽

pp. 37-44

Author(s):

V.V. Bazylev ◽

◽

D.S. Tungusov ◽

A.I. Mikulyak ◽

I.Ya. Senzhapov ◽

...

Keyword(s):

Ejection Fraction ◽

Left Ventricular ◽

Long Term Results ◽

Left Ventricular Aneurysm ◽

Type Ii ◽

Ventricular Aneurysm ◽

Results Of Treatment

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Az ischaemiás eredetű balkamra-aneurysma sebészi rekonstrukciója. Két sebészi technika korai és középtávú eredményei

Orvosi Hetilap ◽

10.1556/650.2018.31226 ◽

2018 ◽

Vol 159 (51) ◽

pp. 2167-2174

Author(s):

Radu Balau ◽

Radu Deac ◽

Judit Kovacs ◽

Marius Harpa ◽

Claudiu Ghiragosian ◽

...

Keyword(s):

Ejection Fraction ◽

Left Ventricular ◽

Functional Class ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Medium Term ◽

Left Ventricular Reconstruction ◽

Ventricular Reconstruction ◽

Group 2 ◽

Patch Group

Abstract: Introduction: Left ventricular aneurysm is a severe complication of acute myocardial infarction, which contributes significantly to mortality and morbidity associated with this pathology. Despite the progress of correction techniques, there are still controversies about the optimal approach addressing this pathology. Aim: The aim of this study was to analyse short and medium term outcomes of left ventricular reconstruction for ischemic left ventricular aneurysm using two surgical techniques (endoventricular patch plasty and liniar suture) in order to determine if one of these techniques has supperior results. Method: 117 patients were included in the study, 48 patients (41%) underwent left ventricular reconstruction with endoventricular patch (Group 1), 69 patients (59%; Group 2) had linear reconstruction. 113 patients (96.5%) required associated procedures: 108 surgical myocardial revascularization, 18 mitral valvuloplasty and 8 ventricular septal defect closure. Short and medium term morbidity, mortality, alteration of ejection fraction and NYHA class were analysed. Results: Perioperative mortality was 11.11%, 4.2% in the endoventricular patch group, and 15.9% in the linear suture group (p = 0.03). The overall 5-year survival was 78.5% (88.7% in Group 1 and 71.2% in Group 2). The left ventricular ejection fraction and NYHA functional class improved in both groups, with greater improvement in the endoventricular patch group. Conclusions: Surgical ventricular reconstruction is a procedure performed for the correction of ischemic left ventricular aneurysm with good early and medium-term results, but with better results with the endoventricular patch technique regarding early and medium-term mortality, ejection fraction and NYHA functional class improvement. Orv Hetil. 2018; 159(51): 2167–2174.

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Surgical management of a giant congenital left ventricular aneurysm in a 2-month-old infant.

10.22541/au.161693988.82901421/v1 ◽

2021 ◽

Author(s):

Oleg Egunov ◽

Evgeniy Krivoshchekov ◽

Frank Cetta ◽

Evgenii Sviazov ◽

Alexander Sokolov

Keyword(s):

Ejection Fraction ◽

Surgical Management ◽

Transthoracic Echocardiography ◽

Clinical Case ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Congenital Left Ventricular Aneurysm ◽

Dor Procedure

This clinical case demonstrated surgical management of a giant congenital left ventricular aneurysm in a 2-month-old female using the Dor procedure. Transthoracic echocardiography performed at 6-month follow-up showed an ejection fraction of 66%.

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