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Background: Post MI LV aneurysm results into dilatation of ventricle, reduced ejection fraction and appearance of mitral regurgitation. LV aneurysm repair was done using CPB by endovascular patch or linear plication. Advantage of aneurysmorrhaphy and off pump CABG may be extended to patient by linear plication of LV aneurysm without CPB.
Methods: From January 2010 to August 2013, 9 patients were operated on for post infarction antero apical aneurysm during off pump CABG. Repair was completed on the beating heart with help of two tissue stabilizer (ACROBAT – i Maquet) applied around the LVA after spreading the suction pods. All patients presented with symptoms of angina or congestive heart failure. Mean pre operative ejection fraction was 27±8%. The mean left ventricular end diastolic diameter was 52.5±9.6cm. Three patients were having moderate to severe MR.
Pre and post operative ejection fraction, left ventricular end diastolic dimension and grade of MR were compared and re accesement were done at 6 month post operatively.
Result: There was no in hospital mortality. Coronary artery bypass was performed with an average 3.2 grafts per patient. At the time of discharge all patients were asymptomatic. There was significant improved in LV ejection fraction and left ventricular end diastolic dimension. Mitral regurgitation was significantly reduced. All these parameters were maintained at 6 months follow-up.
Conclusion: Surgical closure of left ventricular aneurysm especially in antero apical region can easily be performed during off pump coronary artery bypass and stabilization of area with two tissue stabilization facilitate this procedure.