| A Case of Endoventricular Circular
Patch Plasty for Postinfarction Akinetic Aneurysm of Left Ventricle,
Associated with Severe Pulmonary Hypertension and Sustained Ventricular
Tachycardia |
(Department of Cardiovascular Surgery, Saitama Cardiovascular
and Respiratory Center, Saitama, Japan and Department of Cardiovascular
Surgery, Kawasaki City Hospital*, Kawasaki, Japan)
| Motohiro Oshiumi |
Kazuhiro Hashimoto |
Tatsuumi Sasaki |
| Takashi Hachiya |
Katsuhisa Onoguchi |
Hiromitsu Takakura |
| Shigeyuki Takeuchi |
Kiyokazu Kokaji* |
|
|
Endoventricular circular patch plasty
was performed in a 42-year-old man, with a postinfarction akinetic
aneurysm. The case was complicated with severe congestive heart
failure, marked pulmonary hypertension (70% of systemic pressure)
and sustained ventricular tachycardia. Cardiac catheterization
data revealed low ejection fraction (20%), high pulmonary capillary
wedge pressure (33mmHg) and high pulmonary arterial pressure
(70/33mmHg), associated with enlarged end diastolic volume index
(142ml/m2). After the operation, contractile and volumetric improvements
were observed, however the severe pulmonary hypertension remained
without any improvement. Disappearance of life-threatening arrhythmia
allowed his discharge from the hospital, but unsatisfactory hemodynamic
data, except for improved ejection fraction to 49%, turned our
attention to patient selection and alternative treatment (cardiac
transplantation) for such a severe case.
Jpn. J. Cardiovasc. Surg. 30: 44-47 (2001) |
|
