Coronary Artery Bypass Grafting in a Man with Myocardial Ischemia and Left Ventricular Noncompaction

(Department of Cardiovascular Surgery, Social Insurance Kinan Hospital, Wakayama, Japan)

Koichi Maeda Nobuo Sakagoshi Ryohei Matsuura
Yasuhisa Shimazaki
Noncompaction of the left ventricular myocardium(NCLV)is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. The prognosis of NCLV is poor, including progress on to heart failure. However, some cases of NCLV in adults have been recently reported. To the best of our knowledge, there are only 3 cases of cardiac operations reported in patients with NCLV in adults. We describ a 54-year-old man with NCLV and severe coronary artery disease. Echocardiography demonstrated NCLV and low LVEF(25%). Coronary angiography(CAG)showed triple vessel disease with total occlusion of vessels #1 and #6. Tl-cintigraphy and magnetic resonance imaging(MRI)demonstrated viability from the base to the middle of the anterior wall. Coronary artery bypass grafting(CABG)was done after controll of the heart failure. The postoperative course was uneventful and the patient was discharged 7 days after operation. LVEF improved to 52% after surgery. Careful observation of cardiac function is vital because of the possibility of progression to heart failure.
  Jpn. J. Cardiovasc. Surg. 39:191-194(2010)

Keywords:noncompaction of the left ventricular myocardium, old myocardial ischemia, coronary artery bypass grafting, scintigram, magnetic resonance imaging