A Case of Left Ventricular Plasty (SAVE Operation) for a Ventricular Septal Perforation and a Left Ventricular Aneurysm Associated with Acute Myocardial Infarction
10.4326/jjcvs.37.197
- VernacularTitle:急性心筋梗塞に伴う心室中隔穿孔，左室瘤に左室形成術（SAVE 手術）を施行した1例
- Author:
Yoichi Hisata
;
Shiro Hazama
;
Kenta Izumi
;
Kiyoyuki Eishi
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(3):197-200
- CountryJapan
- Language:Japanese
-
Abstract:
A 71-year-old man with obstruction of the left anterior descending branch (#7) suffered an acute myocardial infarction. A ventricular septal perforation (VSP) and a widespread left ventricular aneurysm were detected in the anteroseptal region by both cardiac ultrasonography and cardiac catheterization. Surgery was performed at week 7 after onset. After establishing extracorporeal circulation, the left ventricular aneurysm was longitudinally excised from the left side of the left anterior descending branch while the patient was maintained in a state of cardiac arrest. A septal anterior ventricular exclusion (SAVE) operation was performed using oblong equine pericardial patches to exclude the left ventricular aneurysm and the VSP portion. The VSP was directly closed with sutures because the surrounding tissues were relatively strong at week 7 after the onset of the myocardial infarction and the portion was excluded with an equine pericardial patch. At the same time, CABG (LITA-LAD) was also performed. After surgery, left ventriculography found no residual shunts and we were able to obtain both a good morphology and satisfactory functioning of the left ventricle. The present method is thus considered to be an effective surgical method that excludes both the VSP portion and the infracted portion, while improving the morphology of the left ventricle for VSP with a left ventricular aneurysm.
