Left Ventricular Overlapping Surgery for Broad Ventricular Aneurysm Associated with Cardiac Sarcoidosis:The First Case Report

Jun’ichi Oba＊	Tsukasa Miyatake＊	Kimihiro Yoshimoto＊
Atsushi Okuyama＊	Satoshi Sugimoto＊

（Department of Thoracic and Cardiovascular Surgery, Asahikawa City Hospital＊, Asahikawa, Japan）

Left ventricular overlapping operation was applied to a woman with cardiac sarcoidosis who presented with cardiopulmonary arrest. She did not have any particular history, with minimal risk factors for atherosclerosis. By-stander cardiopulmonary resuscitation delivered by her husband saved her life. Acute coronary syndrome was denied by emergency coronary arteriography. However, left vetriculography revealed broad dyskinetic area inconsistent with coronary distribution. Those findings raised a high suspicion of cardiac sarcoidosis, although this was unconfirmed. Broad ventricular aneurysm and a history of cardiac arrest and congestive heart failure prompted us to operate on her. Left ventricular overlapping operation was applied followed by ICD implantation and steroid induction. The pathologic examination of the ventricular wall showed noncaseous epithelioid granulomas and polynuclear giant cells, which are consistent with cardiac sarcoidosis. She has been leading a healthy daily life without signs of heart failure for one and a half years after discharge. Lesions of cardiac sarcoidosis have a broad spectrum from narrow localized to wide generalized aneurysm. Appropriate surgical strategy should be performed according to the location and the extent of the lesion. Left ventricular overlapping operation is among the alternatives.

 

Jpn. J. Cardiovasc. Surg. 47:228-234（2018）

Keywords：cardiac sarcoidosis;cardiopulmonary arrest;left ventricular overlapping surgery;left ventricular restoration;implantable cardioverter-defibrillator（ICD）