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Case Reports
. 2012;39(5):627-9.

Left ventricular assist device implantation combined with surgical ventricular reconstruction

Alexander M Chernyavskiy  1 , Andrey V Marchenko, Vladimir V Lomivorotov, Dmitriy Doronin, Sergey A Alsov, Alexey Nesmachnyy
Affiliations
Case Reports

Left ventricular assist device implantation combined with surgical ventricular reconstruction

Alexander M Chernyavskiy et al. Tex Heart Inst J. 2012.

Abstract

Nine months after sustaining a transmural anteroseptal myocardial infarction, a 45-year-old man presented with ischemic heart disease, severe mitral valve insufficiency, New York Heart Association functional class IV congestive heart failure, and a left ventricular aneurysm. Coronary angiography revealed 3-vessel disease. Echocardiography showed severe left ventricular impairment, pronounced thrombosis in the left ventricular apex, and low myocardial reserve. To reduce the high risk of performing left ventricular and mitral valve reconstruction concurrently with revascularization, we decided to perform ventricular reconstruction and to implant a Berlin Heart INCOR left ventricular assist device as a bridge to heart transplantation. The patient had an uncomplicated recovery, was discharged from the hospital with symptomatic improvement after 20 days, and was placed on the list for heart transplantation. We describe the patient's case, the surgical procedure, and the reasoning behind the chosen course of treatment.

Keywords: Cardiac surgical procedures/methods; cardiac volume/physiology; heart aneurysm/surgery; heart failure/complications; heart-assist devices; prosthesis implantation/methods; reconstructive surgical procedures; treatment outcome; ventricular dysfunction, left/surgery.

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Figures

None
Fig. 1 Diagrams. A) A thrombus (volume, 100 mL) was removed from the left ventricular apex by means of subendocardial thrombectomy. B) The inflow cannula of the left ventricular assist device was passed through the apical sewing ring and secured with several stitches.
See this image and copyright information in PMC

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