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Eur J Cardiothorac Surg 2008;34:256-261. doi:10.1016/j.ejcts.2008.03.061
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Review

Reconstructive surgery of postinfarction left ventricular aneurysms: techniques and unsolved problems

Mirdavron Mukaddirova, Roland G. Demariaa, Louis P. Perraultb,*, Jean-Marc Frapiera, Bernard Albata

a Department of Thoracic and Cardiovascular Surgery, Arnaud de Villeneuve Hospital, Université de Montpellier I, Montpellier, France
b Department of Surgery and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada

Received 8 January 2008; received in revised form 11 March 2008; accepted 12 March 2008.

* Corresponding author. Address: Research Center, Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec H1T 1C8, Canada. Tel.: +1 514 376 3330x3715; fax: +1 514 376 1355. (Email: louis.perrault{at}icm-mhi.org).


   Abstract
Top
 Abstract
1. Surgical techniques
 2. Unsolved problems
 3. Conclusion
 References
 
The progress in the surgical treatment of postinfarction left ventricular (LV) aneurysm surgery has reduced the operative mortality considerably, while the selection of the optimal LV repair technique remains unclear. Any of the surgical techniques presented in this review has its own advantages and disadvantages. The main goal of this study was to perform a selective literature review of LV aneurysm repair techniques, the most widespread being the linear repair and patch ventriculoplasty.

Key Words: Aneurysm • Arrhythmia surgery • Myocardial infarction • Surgery • Ventricle • Left


   1. Surgical techniques
Top
 Abstract
 1. Surgical techniques
2. Unsolved problems
 3. Conclusion
 References
 
1.1 The pioneering period
The surgical treatment of ventricular aneurysm was introduced in 1944, when Claude S. Beck reinforced the wall of a left ventricular (LV) aneurysm with fascia lata aponeurosis in order to reduce excessive dilatation and avoid LV rupture [1]. However, this was a palliative solution and was not applied further. Likoff and Bailey's approach was more radical. In 1955 they performed closed ventriculoplasty by placing a large vascular clamp on the beating heart tangentially across the base of a LV aneurysm followed by resection and suture [2]. This type of surgery became the forerunner of the linear repair.

Further developments of LV aneurysm surgery lead to the use of numerous new LV reconstruction methods. The eight principal surgical techniques can be divided into two large groups: (1) the direct suture techniques and (2) the patch ventriculoplasty techniques.

1.2 The direct suture techniques
In 1958, Cooley et al. performed the first aneurysm resection and linear repair with use of cardiopulmonary bypass (CPB) [3,4]. The surgery was performed through a median sternotomy approach. Cardioplegia is used especially if additional procedures such as coronary artery bypass grafting (CABG) or valve replacement are needed. Indeed, in case of isolated LV aneurysm resection, cardioplegia is not mandatory and surgery can be performed on the beating or fibrillating heart if the aortic valve is competent. The ventriculotomy is performed by means of linear incision in the aneurismal area parallel to left anterior descending (LAD) or posterior descending (PDA) arteries depending on the localization of the aneurysm. Resection of the aneurysm is performed leaving about 1 cm in width from the scar tissue in order to enable LV wall suture. Incision closure is made by double-row suture: a first row of wide U-shaped horizontal stitch on two continuous Teflon or auto pericardial strips, followed by a second continuous blanket row (Fig. 1 ).


Figure 1
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  		Fig. 1. Linear repair and septoplasties by Cooley. (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) Septal plication and linear closure. (C) Septal plication with help of the separate stitches. (D) Dacron patch sewn to the aneurysmatic interventricular septum. LV: left ventricle.

 
In anterior aneurysms, the interventricular septum is almost universally involved in the scar process. Since the linear reparation technique does not address correction of the septal aneurysm with the associated paradoxical movements and impairment of LV contractility, various technical solutions were proposed to solve this problem.

Cooley suggested two techniques of septoplasty that have become widespread. In the first technique [5], septal plication is performed with the help of separate stitches (Fig. 1C). With the second technique [6], Dacron patch suture of the aneurysmal septal area is used (Fig. 1D). This latter method of septoplasty can be applied to severely thinned septal aneurysms, in order to avoid septal perforation. Both techniques of septoplasty are effective for elimination of paradoxical motion, but create an akinetic zone in the LV. In theory, conservation of an akinetic zone could lead to worsening of congestive heart failure and could adversely affect late surgery results.

In 1973, Stoney et al. [7] suggested a modification of the resection and linear repair technique of LV anteroseptal aneurysms, which includes the scared interventricular septum in the repair and its exclusion from the contractile process (Fig. 2 ). After aneurismal resection, it is essential to examine the endocardial surface of the septum and identify the junction of the anterior scar with the posterior viable myocardium. The lateral edge of myocardium is sutured by continuous suture to the interventricular septum in the border zone (first row). Teflon strips are used in order to reinforce the LV lateral margin, and the stitches are brought out through the septum to the anterior wall of the right ventricle. The repair is completed by a continuous suture (second row), connecting the scar tissue along the LAD with the healthy myocardium of lateral wall of LV (overlap). This technique excludes the possibility of bypass to the LAD because of its inclusion within the suture line. It is also important to note that the most frequent complication during the postoperative period is ventricular tachyarrhythmia [7].


Figure 2
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  		Fig. 2. Repair of anteroseptal ventricular aneurysm by Stoney et al. (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) The stitches were brought out through the septum to the anterior wall of the right ventricle; the LAD inclusion within the suture line. LV: left ventricle; LAD: left anterior descending coronary artery.

 
Another variety of LV aneurysm resection and linear repair technique is the capitonnage technique, introduced by Cabrol et al. in 1974 [8]. This technique uses capitonnage and isolation of the unresectable fibrous zone that creates a new LV cavity with only active contractile segments (Fig. 3 ). The capitonnage is carried out with three rows of polypropylene 2-0 suture. The first row, which is the deepest one, is placed between the LV free wall and the interventricular septum in the area of the border zone near the endocardial fibrous zone. The second row is placed over the first one between the fibrous parts of the interventricular septum and the LV free wall. The third row is superficial and epicardial, and completes the repair.


Figure 3
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  		Fig. 3. The capitonnage technique by Cabrol et al. (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) Capitonnage with use of three rows suture and isolation of unresectable fibrous zone. LV: left ventricle.

 
In 1984, Guilmet et al. [9] proposed the original surgical technique of the overcoat aneurysmoplasty (anévrysmoplastie en paletot). The specific indication for this approach was large LV aneurysms especially when the interventricular septum was involved. The operation entails partial resection of the aneurysmal sac and exteriorization of the scarred septum for its exclusion from the newly formed LV cavity (Fig. 4 ). This technique of repair is also known as Guilmet septoexclusion technique [10]. Incision is carried out from the top upward parallel to the interventricular septum. The partial aneurysm resection is carried out leaving about 1 cm of scar tissue from the left border of the aneurysm. Authors put two suture rows with polypropylene 2-0. The anterior free wall (left border) is sutured at an angle to the septum starting as high as possible and to the apical limit of the sidewall using separate U-shaped sutures within the LV. This first suture row allows exclusion of about 2/3 of the scared zone of septal dyskinesia. The second row is performed by suturing the right border of the aneurysm to the newly formed anterior wall of LV ensuring final hemostasis. Thus, this given technique of LV reconstruction resembles buttoning up a coat.


Figure 4
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  		Fig. 4. The overcoat aneurysmoplasty by Guilmet et al. (anévrysmoplastie en paletot). (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) Exteriorization of the scarred septum for its exclusion from the newly formed LV cavity. LV: left ventricle.

 
1.3 The patch ventriculoplasty techniques
Until the 1980s, the linear closure technique remained the most often used in LV aneurysm surgery.

In 1979, Levinsky et al. described a technique [11] of LV reconstruction with a Dacron patch after resection of an anterior postinfarction aneurysm that rapidly became a popular new technical solution (Fig. 5 ). For failure of the linear repair due to suture tearing through necrotic muscle, a wider resection was carried out to reach viable LV myocardium. Since 6 cm x 12 cm defects are impossible to close by simple approximation, a Dacron patch was sutured to the defect area. Undoubtedly, this technique could be called the precursor of the further methods known under the name patch ventriculoplasty.


Figure 5
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  		Fig. 5. LV reconstruction with a Dacron patch by Levinsky et al. (A) Anteroseptal aneurysm, dotted lines show the large resection borders (up to LV viable myocardium). (B) Dacron patch was continuously sutured to the defect area. LV: left ventricle.

 
In 1985, Jatene and Dor independently reported fundamentally new, so called anatomic LV reconstruction methods with endoventricular circular reduction and stitching patch in the formed ventriculotomy orifice therefore called patch ventriculoplasty [12–14].

The purpose of these methods was to recreate the normal LV geometry so that fibers of healthy myocardium regained their initial orientation. Despite their similarity, both techniques have some differences.

In the LV reconstruction technique by Jatene [12], after ventriculotomy in the aneurysmal area, its resection and thrombectomy from the LV cavity, one or two rows of circular (purse-string) sutures are placed exactly on the border between normal and fibrous tissue. During surgery on the beating heart, the boundary zone is easily defined by palpation, while after cardioplegia it is more difficult to identify this border. Careful tightening of the circular stitches is carried out, reconstructing the LV cavity and reducing its size. The reduction of the orifice between aneurysm and the LV cavity by means of this circular suture prevents elongation when the fibrous rim is approximated.

Afterwards ventriculotomy closure is performed, with or without a patch. If the LV cavity is close to the desired size after circular reduction, the linear closure method, i.e. without patch, can be applied. Herein, the angle stitches are placed on Teflon felt at the transition from normal to fibrous tissue, and the intermediate stitches must leave a fibrous rim, which restores the correct geometry of the ventricular cavity. The longitudinal suture length is significantly shorter than in the usual linear closure.

On the opposite, when the LV cavity is enlarged, a double Dacron patch is stitched in the ventriculotomy orifice (Fig. 6 ). The endoventricular circular suture reduces the patch size and the size of the akinetic zone in the newly formed ventricular cavity. Suturing of the patch can be done either using single U-shaped stitches on Teflon pledgets, or by a continuous suture. To address septal involvement, Jatene used one of the septoplastic techniques offered by Cooley as described previously.


Figure 6
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  		Fig. 6. LV reconstruction technique by Jatene. (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) Septoplasty by Cooley and circular (purse-string) suture exactly on the border between normal and fibrous tissue. (C) LV cavity enlargement with the double Dacron patch, which is stitched in the ventriculotomy orifice area. LV: left ventricle.

 
In the endoventricular circular patch plasty by Dor [13–16], the procedure is carried out under cardioplegia. The left ventriculotomy is performed in the akinetic or dyskinetic zone (transaneurysmal ventriculotomy), the thrombus is removed and, in case of documented spontaneous or induced VT, subtotal endocardial resection and/or cryotherapy without mapping is carried out. An endoventricular circular suture (Fontan maneuver) is placed 1 cm distal to the border of healthy muscle in order to prevent its inclusion and allows recreation of the normal shape of LV using continuous 2-0 monofilament polypropylene suture. Following this, a balloon is placed in LV cavity and inflated to the theoretical diastolic volume of 50–70 ml/m2, and the circular suture is tightened and tied up. This maneuver makes the definition of the circular patch size easier, which can consist of autologous (endocardium or pericardium) or synthetic tissue. The patch size is trimmed to match the circular suture circumference after deflation of the balloon. The patch is fixed by a continuous 2-0 suture inside the LV cavity on the border labeled by the circular suture. Simultaneously, the septoexclusion is created by this patch in the presence of an interventricular septal aneurysm. The excluded fibrous sites can be partially resected and sutured over the patch providing additional hemostasis and precluding the formation of a new cavity (Fig. 7 ).


Figure 7
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  		Fig. 7. The endoventricular circular patch plasty (Dor procedure). (A) Anteroseptal aneurysm, dotted lines show resection borders. (B) The endoventricular circular suture is placed about 1 cm higher than the border of the healthy muscle. (C) The patch is fixed by continuous suture inside the LV cavity on the border labeled by the circular suture; simultaneously the septoexclusion is completed by this patch. The excluded fibrous sites are sutured over the patch. LV: left ventricle.

 
Cooley's work has special value in the development of the patch plasty technique [17–19]. In 1989, Cooley suggested the ventricular endoaneurysmorrhaphy technique [17], as a modified version of LV reconstruction with patch (Fig. 8 ). The intervention is carried out under conditions of hypothermic cardioplegia. The aneurysm is opened in the apical area by a longitudinal incision parallel to interventricular sulcus, with particular attention to avoid the LAD. After LV thrombectomy and identification of the border zone, measurement of the exact size of the defect is performed. An elliptical Dacron patch of the corresponding size is trimmed and sutured to the defect, thus recreating the shape of a normal ventricle, since the scar tissue is outside of the newly formed LV cavity. The excess aneurysmal tissue is excised and the ventriculotomy is closed over the patch by a continuous suture without Teflon or pericardial strips, as this suture line is not submitted to left intraventricular pressure. Moreover, felt strips may become infected [17].


Figure 8
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  		Fig. 8. Ventricular endoaneurysmorrhaphy by Cooley. (A) Anterior aneurysm, dotted lines show resection borders. (B) Elliptical Dacron patch is sutured in the defect area, thus restoring the shape and circuit of the ventricle cavity. LV: left ventricle.

 
The major advantages of the patch ventriculoplasty are recreation of the left ventricular geometry, exclusion of the retractive process, elimination of paradoxical motion and reduction of the akinetic zone. Despite its theoretical advantage, the endoventricular patch is considered an akinetic zone in a newly formed LV cavity, which could affect long-term results, due to progression of heart failure.


   2. Unsolved problems
Top
 Abstract
 1. Surgical techniques
 2. Unsolved problems
3. Conclusion
 References
 
2.1 LV repair technique
Linear repair and patch ventriculoplasty are widely used in the clinical setting. A comparative study of both methods is required. The analysis of the literature shows that the hospital mortality rates range from 0 to 9.8%, the 10-year survival rate ranged from 55.7 to 74% and, overall, showed no significant difference between the linear resection and patch ventriculoplasty groups [20–23].

The analysis of published reports does not allow establishing the superiority of one surgical technique over another one, as the results are quite contradictory and within the statistical error limits.

Different approaches in selection of the type of LV repair are found in the studies comparing the two principal methods. To choose the optimal repair technique, Tavakoli et al. [24] used the assumption that linear closure was preferable in cases of large LV volumes. For patients with extensive septal involvement and with lesions of the subvalvular mitral apparatus, authors favored use of the patch technique. Patch ventriculoplasty was used in patients with severely decreased left ventricular function, in accordance with the point of view of Dor et al. [25], especially in the case of large akinetic area [26].

In the work of Vural et al. [27], the circular patch plasty was performed in case of extensive and definite fibrotic aneurysmal sac with a well-formed neck. Linear closure or small plication was used in small wide-based aneurysms, when the border zone was not well defined. Patch-ventriculoplasty and linear closure supplemented by septoplasty was used in cases with extensive involvement of the septum in the fibrous process.

However, the authors of these two reports found no significant differences between the two repair methods in terms of hospital mortality and long-term survival [24,27]. The only significant difference was a better long-term functional class in the group of patients in whom patch ventriculoplasty was carried out. The left ventricular ejection fraction (LVEF) of residual segments was the main determinant factor influencing the short- and long-term results [27].

In the authors’ opinion, the choice of the LV repair technique should be adapted to each patient's anatomical and physiological characteristics. The use of linear as well as patch repair allows satisfactory results regarding hospital mortality, functional status and long-term survival [24,27].

2.2 Concomitant coronary revascularization
Being an essential part of LV aneurysm surgery, coronary revascularization is performed in 64.6–100% of cases [10,20,21,28].

In the opinion of Lundblad et al., concomitant CABG is mandatory in order to reduce or prevent angina pectoris and the risk of myocardial infarction or worsening of congestive heart failure. Secondly, revascularization of the LAD allows the improvement of septal perfusion and the control of ventricular arrhythmia [28].

Despite lack of significant improvement of long-term survival by concomitant myocardial revascularization, the majority of authors agree on the necessity of concomitant CABG, particularly in patients with the multivessel coronary artery disease [24–30]. According to Vural et al., although CABG did not influence the mortality after operation, it significantly decreased the occurrence of postoperative low cardiac output (LCO) [27].

2.3 Cardiac failure
One of the main causes of the early mortality after aneurysmectomy is LCO. LCO is the most frequent postoperative complication and occurs in 20.9–67% cases [10,21,27,30]. The need for temporary hemodynamic support with intra-aortic balloons varies from 1.8 to 17.9%, with no significant difference between the linear and patch groups [21,22,24,29]. LCO is the cause of early mortality in 44.4–86.7% after aneurysmectomy [27,31]. Low LVEF, high left ventricular end-diastolic pressure, prolonged aortic cross-clamp time are associated with postoperative LCO [20,24,27,28]. The most important predictor is the contractility of the remaining segments of the LV after resection of noncontractile aneurysmal tissues [28]. These factors also have a negative influence on long-term survival after LV aneurysmectomy, and are responsible for the 26.3–40% late mortality rate due to end stage congestive heart failure [30,32].

2.4 Ventricular tachyarrhythmias
In 1958, Couch performed the first successful surgical ablation of the ventricular tachycardia by means of LV aneurysmectomy [33], starting the era of ventricular tachyarrhythmia surgery. However, isolated aneurysmectomy was accompanied by a high rate recurrence of ventricular tachycardia with a high incidence of sudden death after surgery [31,32,34]. Baufreton et al. showed a 29.6% rate of mortality within the first 30 postoperative days caused by intractable ventricular tachycardia [31]. Matthias and Bechtel et al. investigating the surgical results of 147 patients treated by anterior LV aneurysm resection without concomitant anti-arrhythmic procedures demonstrated that sudden arrhythmic death occurred in 36.8% of deceased patients during 5 years of follow-up [32]. In this regard, LV aneurysm resection should be supplemented with one of the surgical procedures directed at destruction or isolation of arrhythmogenic focuses when VT is inducible by preoperative electrophysiologic study (EPS) or presents spontaneously, which includes circular endocardial ventriculotomy [35], subtotal endocardial scar resection [36–38], endocardial cryoablation [39–41] or laser photocoagulation [42,43]. By now, several authors have reported satisfactory results of anti-arrhythmic surgery in patients with LV postinfarction aneurysm at long-term after operation [30,37,44]. Postoperative EPS remains mandatory to ascertain the surgical results and the need for supplemental cardioverter defibrillator implantation in case of ventricular tachycardia being inducible [30].

The palliative solution of late ventricular tachyarrhythmia problem after isolated aneurysmectomy is also the implantation of cardioverter-defibrillators. Despite the results of a number of multicenter trials (MADIT, AVID, MUSTT, MADIT II), showing that automatic implantable defibrillators have significantly reduced the mortality in comparison to the drug therapy, the short- and long-term mortality after defibrillator implantation is still considerable in patients with severe ischemic cardiomyopathy [45–48].


   3. Conclusion
Top
 Abstract
 1. Surgical techniques
 2. Unsolved problems
 3. Conclusion
References
 
Sixty years of evolution in post infarction LV aneurysm surgery has allowed the reduction of patient mortality to a considerable degree raising, at the same time, the issue of optimal selection of LV repair technique. The surgical techniques presented have their own advantages as well as disadvantages. Variability of indications and anatomic and physiological features in each specific case usually makes one surgeon's choice debatable. The choice of LV repair technique and necessity of concomitant procedures should be guided by the patients’ preoperative characteristics, projected hospital mortality, clinical status and long-term survival after operation.


   Acknowledgments
 
We thank Jean-Claude Sinquet, perfusionist of our department, for his substantial help with artwork of this review.


   References
Top
 Abstract
 1. Surgical techniques
 2. Unsolved problems
 3. Conclusion
 References
 

  1. Beck CS. Operation for aneurysm of the heart. Ann Surg 1944;120:34.[CrossRef][Medline]
  2. Likoff W, Bailey CP. Ventriculoplasty: excision of myocardial aneurysm; report of a successful case. JAMA 1955;158:915-920.[Medline]
  3. Cooley DA, Collins HA, Morris Jr. GC, Chapman DW. Ventricular aneurysm after myocardial infarction: surgical excision with use of temporary cardiopulmonary bypass. JAMA 1958;167:557-560.[Medline]
  4. Cooley DA. Ventricular aneurysm after myocardial infarction: surgical excision with use of temporary cardiopulmonary bypass. Ann Thorac Surg 1988;46:589.[Medline]
  5. Cooley DA, Walker WE. Technique of ventricular septoplasty. In: Moran JM, Michaelis LL, editors. Surgery for the complications of myocardial infarction. Grune & Stratton, Inc.; 1980. pp. 279.
  6. Reddy SB, Cooley DA, Duncan JM, Norman JC. Left ventricular aneurysm: twenty-year surgical experience with 1572 patients at the Texas Heart Institute. Cardiovascular diseases. Bull Texas Heart Inst 1981;8:165-186.
  7. Stoney WS, Alford WC, Burrus GR, Thomas CS. Repair of anteroseptal ventricular aneurysm. Ann Thorac Surg 1973;15:394-404.[Medline]
  8. Cabrol A, Guiraudon G, Laughlin L, Mattei S, Luciani J, Leon L, Renou J. Resection of left ventricular aneurysms and fibrous plaques. J Cardiovasc Surg (Torino) 1974;15:72-73.[Medline]
  9. Guilmet D, Popoff G, Dubois C, Tawil N, Bachet J, Goudot B, Guermonprez JL, Brodaty D, Schlumberger S. Nouvelle technique chirurgicale pour la cure des anévrysmes du ventricule gauche: l’anévrysmoplastie en paletot. Résultats préliminaires. 11 observations. Arch Mal Coeur Vaiss 1984;77:953-958.[Medline]
  10. Calafiore AM, Gallina S, Di Mauro M, Pano M, Teodori G, Di Giammarco G, Contini M, Iaco AL, Vitolla G. Left ventricular aneurysmectomy: endoventricular circular patch plasty or septoexclusion. Symposium on left ventricular volume reduction, Part I. J Cardiac Surg 2003;18:93-100.[CrossRef][Medline]
  11. Levinsky L, Arani DT, Raza ST, Kohn R, Schimert G. Dacron patch enlargement of anterior wall of left ventricle after aneurysmectomy with concomitant infarctectomy. J Thorac Cardiovasc Surg 1979;77:753-756.[Abstract]
  12. Jatene A. Left ventricular aneurysmectomy. Resection or reconstruction. J Thorac Cardiovasc Surg 1985;89:321-331.[Medline]
  13. Dor V, Kreitmann P, Jourdan J, Acar C, Saab M, Coste P, Viglione J. Interest of physiological closure (circumferential plasty on contractive areas) of left ventricle after resection and endocardectomy for aneurysm or akinetic zone comparison with classical technique about a series of 209 left ventricular resections. J Cardiovasc Surg 1985;26:73[abstract].
  14. Dor V, Saab M, Coste P, Kornaszewska M, Montiglio F. Left ventricular aneurysm: a new surgical approach. J Thorac Cardiovasc Surg 1989;37:11-19.
  15. Dor V. Left ventricular aneurysms: the endoventricular circular patch plasty. Semin Thorac Cardiovasc Surg 1997;9:123-130.[Medline]
  16. Dor V. The endoventricular circular patch plasty (Dor procedure) in ischemic akinetic dilated ventricles. Heart Failure Rev 2001;6:187-193.[CrossRef][Medline]
  17. Cooley DA. Ventricular endoaneurysmorrhaphy: a simplified repair for extensive postinfarction aneurysm. J Cardiac Surg 1989;4:200-205.[Medline]
  18. Cooley DA. Repair of the calcified ventricular aneurysm. Ann Thorac Surg 1990;49:489-490.[Abstract]
  19. Cooley DA, Frazier OH, Duncan JM, Reul GJ, Krajcer Z. Intracavitary repair of ventricular aneurysm and regional dyskinesia. Ann Surg 1992;215:417-424.[Medline]
  20. Vicol C, Rupp G, Fischer S, Summer C, Dietrich Bolte H, Struck E. Linear repair versus ventricular reconstruction for treatment of left ventricular aneurysm: a 10-year experience. J Cardiovasc Surg (Torino) 1998;39:461-467.[Medline]
  21. Antunes PE, Silva R, de Oliveira JF, Antunes MJ. Left ventricular aneurysms: early and long-term results of two types of repair. Eur J Cardiothorac Surg 2005;27:210-215.[Abstract/Free Full Text]
  22. Lange R, Guenther T, Augustin N, Noebauer C, Wottke M, Busch R, Mayr N, Meisner H, Holper K. Absent long-term benefit of patch versus linear reconstruction in left ventricular aneurysm surgery. Ann Thorac Surg 2005;80:537-542.[Abstract/Free Full Text]
  23. Minami K, Amin-Parsa MH, Reiss N, Schulte-Eistrup S, Coskun O, Koerfer R. Left ventricular aneurysmectomy, a 10-year experience in 269 patients. J Cardiovasc Surg 2003;44(5 Suppl. 1):64[abstract].
  24. Tavakoli R, Bettex D, Weber A, Brunner H, Genoni M, Pretre R, Jenni R, Turina M. Repair of postinfarction dyskinetic LV aneurysm with either linear or patch technique. Eur J Cardiothorac Surg 2002;22:129-134.[Abstract/Free Full Text]
  25. Dor V, Sabatier M, Di Donato M, Montiglio F, Toso A, Maioli M. Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction: comparison with a series of large dyskinetic scars. J Thorac Cardiovasc Surg 1998;116:50-59.[Abstract/Free Full Text]
  26. Athanasuleas CL, Buckberg GD, Stanley AW, Siler W, Dor V, Di Donato M, Menicanti L, Almeida de Oliveira S, Beyersdorf F, Kron IL, Suma H, Kouchoukos NT, Moore W, McCarthy PM, Oz MC, Fontan F, Scott ML, Accola KA, RESTORE group Surgical ventricular restoration in the treatment of congestive heart failure due to post-infarction ventricular dilation. J Am Coll Cardiol 2004;44:1439-1445.[Abstract/Free Full Text]
  27. Vural KM, Sener E, Ozatik MA, Tasdemir O, Bayazit K. Left ventricular aneurysm repair: an assessment of surgical treatment modalities. Eur J Cardiothorac Surg 1998;13:49-56.[Abstract/Free Full Text]
  28. Lundblad R, Abdelnoor M, Svennevig JL. Surgery for left ventricular aneurysm: early and late survival after simple linear repair and endoventricular patch plasty. J Thorac Cardiovasc Surg 2004;128:449-456.[Abstract/Free Full Text]
  29. Shapira OM, Davidoff R, Hilkert RJ, Aldea GS, Fitzgerald CA, Shemin RJ. Repair of left ventricular aneurysm: long-term results of linear repair versus endoaneurysmorrhaphy. Ann Thorac Surg 1997;63:701-705.[Abstract/Free Full Text]
  30. Demaria RG, Mukaddirov M, Rouviere P, Barbotte E, Celton B, Albat B, Frapier JM. Long-term outcomes after cryoablation for ventricular tachycardia during surgical treatment of anterior ventricular aneurysms. Pacing Clin Electrophysiol 2005;28(Suppl. 1):168-171.[CrossRef][Medline]
  31. Baufreton C, Bertand S, Hillion ML, Loisance D. Facteurs de risque de mortalité hospitalière après réparation linéaire des anévrysmes ventriculaires gauches. J Chir Thorac Cardio-Vasc 2002;6:11-16.
  32. Matthias Bechtel JF, Tolg R, Graf B, Richardt G, Noetzold A, Kraatz EG, Sievers HH, Bartels C. High incidence of sudden death late after anterior LV-aneurysm repair. Eur J Cardiothorac Surg 2004;25:807-811.[Abstract/Free Full Text]
  33. Couch OA. Cardiac aneurysm with ventricular tachycardia and subsequent excision of aneurysm. Circulation 1959;20:251-253.[Abstract/Free Full Text]
  34. Tomizawa Y, Endo M, Nishida H, Koyanagi H. Surgical repair of left ventricular aneurysm: long-term results. Kyobu Geka 2003;56:528-531.[Medline]
  35. Guiraudon G, Fontaine G, Frank R, Escande G, Etievent P, Cabrol C. Encircling endocardial ventriculotomy: a new surgical treatment for life-threatening ventricular tachycardias resistant to medical treatment following myocardial infarction. Ann Thorac Surg 1978;26:438-444.[Abstract]
  36. Harken AH, Josephson ME, Horowitz LN. Surgical endocardial resection for the treatment of malignant ventricular tachycardia. Ann Surg 1979;190:456-460.[Medline]
  37. Dor V, Sabatier M, Montiglio F, Rossi P, Toso A, Di Donato M. Results of non-guided subtotal endocardiectomy associated with left ventricular reconstruction in patients with ischemic ventricular arrhythmias. J Thorac Cardiovasc Surg 1994;103:1301-1308.
  38. Bakker PF, de Lange F, Hauer RN, Derksen R, de Bakker JM. Sequential map-guided endocardial resection for ventricular tachycardia improves outcome. Eur J Cardiothorac Surg 2001;19:448-454.[Abstract/Free Full Text]
  39. Guiraudon GM, Klein GJ, Vermeulen FE, Yee R, Van Hemel NM. Encircling endocardial cryoablation: a technique for surgical treatment of ventricular tachycardia after myocardial infarction. Circulation 1983;68(Suppl.):III-176.
  40. Guiraudon GM, Thakur RK, Klein GJ, Yee R, Guiraudon CM, Sharma A. Encircling endocardial cryoablation for ventricular tachycardia after myocardial infarction: experience with 33 patients. Am Heart J 1994;128:982-989.[CrossRef][Medline]
  41. Frapier J-M, Hubaut J-J, Pasquie J-L, Chaptal PA. Large encircling cryoablation without mapping for ventricular tachycardia after anterior myocardial infarction: long-term outcome. J Thorac Cardiovasc Surg 1998;116:578-583.[Abstract/Free Full Text]
  42. Selle JG, Svenson RH, Gallagher JJ, Littmann L, Sealy WC, Robicsek F. Surgical treatment of ventricular tachycardia with Nd: YAG laser photocoagulation. Pacing Clin Electrophysiol 1992;15:1357-1361.[Medline]
  43. Pfeiffer D, Moosdorf R, Svenson RH, Littmann L, Grimm W, Kirchhoff PG, Luderitz B. Epicardial neodymium-YAG laser photocoagulation of ventricular tachycardia without ventriculotomy in patients after myocardial infarction. Circulation 1996;94:3221-3225.[Abstract/Free Full Text]
  44. Shumway SJ, Johnson EM, Svendsen CA, Kriett JM, Ring WS. Surgical management of ventricular tachycardia. Ann Thorac Surg 1997;63:1589-1591.[Abstract/Free Full Text]
  45. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, Levine JH, Saksena S, Waldo AL, Wilber D, Brown MW, Heo M. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmias. Multicentral Automatic Defibrillator Implantation Trial (MADIT). N Engl J Med 1996;335:1933-1940.[Abstract/Free Full Text]
  46. The Antiarrhythmics vs Implantable Defibrillators (AVID) Investigators A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near fatal ventricular arrhythmias. N Engl J Med 1997;337:1576-1583.[Abstract/Free Full Text]
  47. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G, for the Multicenter UnSustained Tachycardia Trial Investigators (MUSTT) A randomized study of the prevention of sudden death in patients with coronary artery diseases. N Engl J Med 1999;341:1882-1890.[Abstract/Free Full Text]
  48. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, Daubert JP, Higgins SL, Brown MW, Andrews ML, for the Multicenter Automatic Defibrillator Implantation Trial II Investigators (MADIT II) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877-883.[Abstract/Free Full Text]




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