Successful ventricular remodeling with coronary artery bypass grafting and mitral valve repair in a patient with severe heart failure

Abstract

Left ventricular remodeling is becoming a frequent treatment for severe heart failure, but its use in combination with other surgical techniques is controversial. We report a case in which left ventricular remodeling was combined with coronary artery bypass grafting and mitral valve repair to treat a patient with severely depressed ejection fraction, mitral insufficiency, coronary artery disease, and a recent history of myocardial infarction. Cardiac function improved after the combined treatment. This case suggests that left ventricular remodeling can be used safely and effectively in conjunction with other surgical techniques.

Fig. 1 The left ventricle after ventricular resection. This view is from the anesthesiologist's position. The incision is carried up from the ventricular apex approximately 1 cm parallel to the left anterior descending coronary artery. A single suture is being placed at the margin of resection for the ventricular patch.

Fig. 2 Completed ventricular remodeling. This view is from the anesthesiologist's position. The linear repair of the anterior left ventricle is reinforced by its placement between 2 Teflon pledgets. The patch repair underlies the linear repair.