Combined Off Pump Left Ventricular Aneurysm Plication and Multivessel Coronary Revascularization in Patients with Ischaemic Cardiomyopathy

This retrospective study evaluated the feasibility of surgical endoepicardial linear ablation for ventricular tachycardia in patients with postinfarction left ventricular aneurysm. Sixty-four patients with multivessel coronary artery disease and left ventricular aneurysm but no mural thrombosis of the aneurysm or valve disease were treated at our institution from March 2012 through July 2015. All underwent off-pump coronary artery bypass grafting and left ventricular aneurysm repair by linear plication. Twenty-three patients (35.9%) had ventricular tachycardia and underwent surgical endoepicardial linear ablation on the beating heart guided by epicardial substrate mapping with the Carto 3 system. The remaining 41 patients (64.1%) composed the no-ablation group. The effectiveness of surgical linear ablation in the ablation group was evaluated. Safety and clinical outcomes were evaluated and compared between the groups. The ventricular tachycardia recurrence rate in the ablation group was 17.4% in the immediate postoperative period and 23.8% at last follow-up (39 ± 21 mo). Early (<30-d) mortality rates were 8.7% in the ablation group and 4.9% in the no-ablation group (P=0.41); the respective late mortality rates were 19.1% and 18% (P=0.70). Multivariate Cox regression analysis indicated that preoperatively poor left ventricular function was an independent risk factor for early and late death in both groups. The groups were similar in terms of the need for postoperative mechanical circulatory support, intensive care unit stay, and cumulative survival rate. We conclude that, for carefully selected candidates, surgical endoepicardial linear ablation combined with off-pump coronary artery bypass grafting and left ventricular aneurysm linear plication is a feasible treatment for ventricular tachycardia with postinfarction left ventricular aneurysm.

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An Experimental Rabbit Model for Off-Pump Left Ventricular Reconstruction Following Left Ventricular Aneurysm

The Heart Surgery Forum ◽

10.1532/hsf98.20061035 ◽

2006 ◽

Vol 9 (5) ◽

pp. E786-E791 ◽

Cited By ~ 1

Author(s):

Yoshio Ootaki ◽

Hirotsugu Yamada ◽

Masao Daimon ◽

Keiji Kamohara ◽

Zoran Popović ◽

...

Keyword(s):

Rabbit Model ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Off Pump ◽

Left Ventricular Reconstruction ◽

Ventricular Reconstruction

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Left Ventricular Aneurysm Repair – Off Pump Beating Heart Surgery How to do it?

Apollo Medicine ◽

10.1016/s0976-0016(11)60450-x ◽

2007 ◽

Vol 4 (3) ◽

pp. 207-209

Author(s):

Ritwick Raj Bhuyan ◽

Ratna Malika Kumar ◽

Bhabananda Das

Keyword(s):

Heart Surgery ◽

Left Ventricular ◽

Beating Heart ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Beating Heart Surgery ◽

Off Pump ◽

Aneurysm Repair

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Repeat coronary artery bypass grafting using in combination with resection of post-infarction left ventricular aneurysm off-pump, 10 years after primary autovenous coronary artery bypass grafting.

The Bulletin of Bakoulev Center Cardiovascular Diseases ◽

10.24022/1810-0694-2018-19-4-554-558 ◽

2018 ◽

Vol 19 (4) ◽

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Bypass Grafting ◽

Ventricular Aneurysm ◽

Artery Bypass Grafting ◽

Off Pump

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ON-PUMP BEATING HEART MYOCARDIAL REVASCULARIZATION FOR HIGH RISK PATIENTS

Clinical Practice ◽

10.17816/clinpract7346-52 ◽

2016 ◽

Vol 7 (3) ◽

pp. 46-52

Author(s):

A S Zotov ◽

T V Klypa ◽

D V Borisov ◽

M V Ilyin

Keyword(s):

Carotid Endarterectomy ◽

Coronary Revascularization ◽

Artery Bypass ◽

Myocardial Revascularization ◽

Left Ventricular ◽

Beating Heart ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Risk Patients ◽

Aneurysm Repair

107 patients with mean ejection fraction 40,6±7,4% underwent on-pump-beating heart coronary revascularization and associated procedures. There were 76 men and 31 women, with a mean age of 68,9±7,8 years. Five patients required carotid endarterectomy and twelve patients required left ventricular aneurysm repair. 5 patients underwent carotid endarterectomy and 12 patients - left ventricular aneurysm repair. The mean number of graft/patient was 2,9±0,8. Postoperatively occurred the following complications: acute ischemic stroke - 1 (0.9%), acute heart failure - 1 (0.9%), respiratory failure - 2 (1.9%) and bleeding required surgical revision - 1 (0.9%). Hospital mortality rate was 0,9% (1 of the 107 patients). On-pump beating heart technique is a safe and efficient method for coronary artery bypass grafting and associated procedures (carotid endarterectomy, left ventricular aneurysm repair).

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