title: Left ventricular assist device implantation combined with surgical ventricular reconstruction.
abstract: Nine months after sustaining a transmural anteroseptal myocardial infarction, a 45-year-old man presented with ischemic heart disease, severe mitral valve insufficiency, New York Heart Association functional class IV congestive heart failure, and a left ventricular aneurysm. Coronary angiography revealed 3-vessel disease. Echocardiography showed severe left ventricular impairment, pronounced thrombosis in the left ventricular apex, and low myocardial reserve. To reduce the high risk of performing left ventricular and mitral valve reconstruction concurrently with revascularization, we decided to perform ventricular reconstruction and to implant a Berlin Heart INCOR left ventricular assist device as a bridge to heart transplantation. The patient had an uncomplicated recovery, was discharged from the hospital with symptomatic improvement after 20 days, and was placed on the list for heart transplantation. We describe the patient's case, the surgical procedure, and the reasoning behind the chosen course of treatment.
authors.affiliation: Aorta and Coronary Arteries Surgery Department, Research Institute of Circulation Pathology, Novosibirsk 630055, Russia.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Chernyavskiy
authors.forename: Andrey V
authors.initials: AV
authors.lastname: Marchenko
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Doronin
authors.forename: Sergey A
authors.initials: SA
authors.lastname: Alsov
authors.forename: Alexey
authors.initials: A
authors.lastname: Nesmachnyy
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000150:complications*; D006348:Cardiac Surgical Procedures; D002407:Catheterization, Swan-Ganz; D017023:Coronary Angiography; D025401:Echocardiography, Stress; D006322:Heart Aneurysm / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014850:Waiting Lists
keywords: Cardiac surgical procedures/methods; cardiac volume/physiology; heart aneurysm/surgery; heart failure/complications; heart-assist devices; prosthesis implantation/methods; reconstructive surgical procedures; treatment outcome; ventricular dysfunction, left/surgery