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DOI: 10.1055/s-2007-967435
New surgical technique for left ventricle volume restoration- Computer assisted left ventricle engineering
Acute myocardial infarction is still often followed by left ventricle aneurysms despite the aggressive percutaneous intervention techniques. Deterioration in left ventricle geometry will decrease the myocardial fibre shortening, increase diastolic relaxation time, stress on the remaining left ventricle wall, thus the oxygen consumption of the myocardium. The change in oxygen balance will be worsening by the volume overload.
Several surgical technique is known today, such as plication, resection, or the Dor and Jatene techniques. The basic concept of all these techniques is to find the precise edge of the myocardium and the aneurysm, and exclude the akinetic part of the ventricle. However, very often this edge is not detectable, making the surgeon blind. The other problem is the remaining left ventricle volume after operation. A feared problem is a small left ventricle causing low cardiac output (LCO) postoperatively.
11 patients with ischaemic coronary disease and left ventricle aneurysm underwent CT images were acquired on a General Electric UltraSpeed instrument (8 detector rows) powered by GE's Helios software. 1.25mm thick slices were reconstructed with 1.25mm reconstruction interval. With ECG guidance we designed the new left ventricle in systolic position, and calculated the remnant left ventricle volumes. Modified Jatene procedure was done with the calculated parameters given by the computer.
No LCO syndrome occurred, and all postoperative Echocardiography showed excellent left ventricle geometry.