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Eur J Cardiothorac Surg 2005;28:772-774
© 2005 Elsevier Science NL

How-to-do-it

Restoring an elliptical chamber during rebuilding a wrap around anterior infarction

^a David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 62-258 CHS, Los Angeles, CA 90095-1741, USA
^b San Donato Hospital, Via Morandi 30, Milan, Italy
^c University of Sao Paulo Medical School, Sao Paulo, Brazil
^d Norwood Clinic, 1528 Carraway Blvd., Birmingham, AL, USA

Received 27 June 2005; received in revised form 12 August 2005; accepted 16 August 2005.

^_* Corresponding author. Tel.: +1 310 206 1027; fax: +1 310 825 5895. (Email: gbuckberg{at}mednet.ucla.edu; menicanti{at}libero.it; sergioaoliveira{at}incor.usp.br; dra{at}norwoodclinic.com).

Left ventricular geometry is distorted after anterior infarction caused by occlusion of a wrap around left anterior descending artery. Loss of the apex creates a spherical left ventricular (LV) chamber, whose rebuilding requires reconstruction techniques that exclude the non-functional inferior wall. The described technique of tailoring the apex defines a way to create an oblique elliptical rim for subsequent patch placement to complete the restoration procedure. This method of ventricular rebuilding differs from methods that follow the inferior wall scar, which result in a restoration procedure that leaves a spherical or box-like apical region.

Key Words: Wrap around anterior infarction • Conical chamber • SVR • Ventricular restoration

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