[A new surgical technic for the treatment of left ventricular aneurysm: the overcoat aneurysmoplasty. Preliminary results. 11 cases].

Abstract

The classical surgical techniques used in post-myocardial infarction left ventricular aneurysms consist in resecting as much as possible of visible fibrous tissues and closure of the two borders by "U"--shaped sutures supported by a Teflon bond. There are two drawbacks to this approach: resection often involves the surface arterial network which often has a significant role to play in vascularising the remaining myocardium; fibrous, akinetic or dyskinetic zones of the anterior 2/3 of the interventricular septum cannot be resected. The proposed technique consists in limiting the surface of resection and in lowering the left border of the aneurysm as far as the posterior 1/3 of the septum. The septum is then sutured over the aneurysm to the antero-lateral wall of the left ventricle. Ten patients were operated using this technique: there were no operative deaths; preoperative cardiac failure regressed in 4 out of 5 patients; one patient was operated for unstable ventricular tachycardia, the arrhythmias disappeared after surgery; one patient operated during the 3rd week for left ventricular pseudo-aneurysm required intra-aortic balloon pumping and developed episodes of VT which finally resolved.