Geometric reconstruction of a left ventricular aneurysm with coronary artery bypass graft

Abstract

Left ventricular aneurysm is a late mechanical complication of untreated acute myocardial infarction. It has become relatively rare since the development of percutaneous cardiac intervention. Most aneurysms are located at the anterior ventricular wall, and are caused by total occlusion of the left anterior descending artery. Usually, the anterior and apical walls initially become akinetic; this can sometimes evolve into dyskinesia. Thrombus formation is a common finding, since the apical contractility is impaired. This tutorial illustrates the challenging technical aspects of a large thrombus removal, along with the geometric reconstruction of the left ventricular aneurysm and coronary bypass surgery.