Non-ischaemic intramyocardial dissection following total arch replacement

Intramyocardial dissection (ID) is a rare left ventricular (LV) disorder characterized by myocardial fibre dissection and neocavitation. In this study, we present a rare case of a 66-year-old woman who had a history of sarcoidosis with non-ischaemic ID following total arch replacement. ID developed suddenly in the free wall of the LV and expanded rapidly to form an LV aneurysm. We successfully performed LV reconstructive surgery to prevent ID rupture.

Left ventricle: morphology and geometry

The left ventricle is a cone-shaped muscular pump which receives the blood from the left atrium through the inflow tract and ejects it to the aorta through the outflow tract. The double helical myocardial fibre formation is the basis of efficient motion, function, and morphology of the left ventricle. Physiological or pathological changes of these characteristics of the left ventricle can be evaluated by echocardiography. This chapter describes the morphology and geometry of the left ventricle, including the inflow tract, the outflow tract, double helix formation of left ventricle myocardium, and the echocardiographic assessment of left ventricle morphology and geometry.