scholarly journals Case Study: Using 3D Speckle Tracking Echocardiography for Left Ventricular Aneurysm Diagnosis

2020 ◽  
pp. 90-95
Author(s):  
O. A. Mazur ◽  
L. M. Hrubyak ◽  
O. V. Kupchynskyi ◽  
N. V. Bankovska
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Left Ventricular Aneurysm ◽  
Apical Region ◽  
Ventricular Aneurysm

Nowadays magnetic resonance imaging (MRI) is a gold standard for diagnosing abnormalities of left ventricular geometry and function, however, it is not universally accessible. Furthermore, MRI is not compatible with pacemakers and similar devices. 3D speckle tracking echocardiography (3D STE) is a cutting-edge echocardiography imaging technique for myocardial deformation assessment. As such, 3D STE looks very promising for diagnosing structural complications of myocardial infarction (MI) and choosing the optimal surgical techniques. In this case study, we used 3D STE to assess left ventricular function in a patient with left ventricular aneurysm. The patient was admitted to National Amosov Institute of Cardiovascular Surgery three weeks after having a second MI (the first MI was reported 4 years ago). His coronary angiography showed diffuse coronary artery disease. 2D echocardiography (performed on Toshiba Artida) results: end-diastolic volume (EDV) 206 ml, end-systolic volume (ESV) 141 ml, ejection fraction (EF) (Simpson’s method) 31%. An object sized 2.2*1.6 cm was discovered in the apical region (left ventricular thrombus). 3D STE results: EDV 209 ml, ESV 182 ml, EF 13%. Global area strain (GAS) was considerably decreased (–13.7 %) showing the pattern of ischemic cardiomyopathy with multivessel disease. Due to several reasons, it was impossible to obtain an MRI scan, so a CT coronary angiography was performed (Toshiba Aquilion One). The results of multi-slice computed tomography (MSCT) were consistent with those of echocardiography. According to the results, the initial plan to resect the apical akinesia region was ruled out. The patient underwent coronary artery bypass grafting (CABG) (4 shunts), the removal of thrombi from the left ventricle (additional fresh thrombi were discovered during the surgical intervention), and left ventricular aneurysm repair under cardiopulmonary bypass. Post-treatment 3D STE results: EDV dropped to 135 ml, EF rose from 13% to 32%. GAS increased up to –20.4 %, while the strains of all segments increased to subnormal levels. The overall dynamics was positive, and the patient was discharged to undergo postoperative rehabilitation. The case shows that 3D STE data is consistent with CT data in patients with abnormal ventricular remodeling. 3D STE is a good method for differentiation between akinetic scar tissue and a dyskinetic left ventricular aneurysm.

scholarly journals A case of left ventricular aneurysm associated with an anomalous coronary artery.

1988 ◽  
Vol 52 (1) ◽  
pp. 79-83 ◽  
Author(s):  
TAKAFUMI HIRO ◽  
MASUNORI MATSUZAKI ◽  
JUNKO HIRO ◽  
MASAHARU OZAKI ◽  
HIROSHI OGAWA ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Anomalous Coronary Artery ◽  
Ventricular Aneurysm ◽  
Anomalous Coronary

scholarly journals A combined approach to correct posterior left ventricular aneurysm, aortic stenosis and coronary artery disease

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Akshay J Patel ◽  
Saifullah Mohamed ◽  
Yassir Iqbal ◽  
Ashok Kar ◽  
Gopal Soppa
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Suture Technique ◽  
Left Ventricular Aneurysm ◽  
Ventricular Aneurysm ◽  
Mattress Suture

Abstract Ischaemic heart disease and aortic stenosis are potentially life-threatening conditions. A post-infarct left ventricular aneurysm, when combined with the above, is particularly hazardous. We present a case where all three conditions occurred simultaneously and describe the surgical approach undertaken to attempt correction. The patient underwent aneurysmectomy together with aortic valve replacement and two-vessel coronary artery bypass grafting. The aneurysm was excised with direct linear closure of the walls using a Teflon-buttressed interrupted mattress suture technique. Post-operatively, ventricular systolic function was good (LVEF 40%) together with a well-seated aortic valve showing no paravalvular leaks. This case highlights the importance of meticulous removal of thrombus from the aneurysm and everting the edges thereby eliminating a thrombogenic surface and the risk of embolic stroke. The restorative procedure itself serves to underline the importance of ventricular shape in the effective functioning of the myocardium for sustaining an adequate stroke volume with normalized physiology.

Surgical Treatment of Left Ventricular Aneurysm

2009 ◽  
Vol 17 (5) ◽  
pp. 490-493 ◽  
Author(s):  
Kasim Oguz Coskun ◽  
Aron Frederik Popov ◽  
Sinan Tolga Coskun ◽  
Jose Hinz ◽  
Jan Dieter Schmitto ◽  
...  
Keyword(s):  
Clinical Status ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Left Ventricular Aneurysm ◽  
Hemodynamic Parameters ◽  
Ventricular Aneurysm ◽  
Normal Left Ventricular ◽  
Dor Procedure ◽  
Late Survival ◽  
Echocardiographic Findings

When a left ventricular aneurysm leads to pulmonary congestive symptoms, aneurysmectomy may provide relief. This retrospective study included 269 patients who underwent aneurysmectomy between 1993 and 2002, by the classic Cooley operation in 164 and by Dor ventriculoplasty in 105. There were no significant differences in early and late survival between groups, although the frequency of extended anteroseptal infarction was higher in patients undergoing the Dor procedure. Postoperative echocardiographic findings showed significant improvements in left ventricular function in both groups, in terms of end-diastolic and end-systolic dimensions and ejection fraction. Left ventricular aneurysmectomy significantly improved the clinical status and hemodynamic parameters of symptomatic patients. The choice of surgical technique depends on the extent of the scar segment, especially the presence of an anteroseptal scarred area. The Dor procedure is more suitable for restoring normal left ventricular geometry in patients with extensive septal infarction.

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