Procedure

Ventricular reconstruction or aneurysm repair using a modified linear repair technique with septal patch when indicated

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

^* Corresponding author: ^* 1221 Gervais Road, RR#1 Waubaushene, Toronto, Ont., L0K 2C0, Canada. Tel. +1-705-534-7382; fax: +1-705-534-1538, E-mail: l.mickleborough{at}on.aibn.com

A presentation of our approach for ventricular reconstruction or aneurysm resection which includes a modified linear closure plus septal patch technique when indicated. Our philosophy regarding reconstruction combined with coronary artery bypass grafting (CABG) versus revascularization alone is reviewed. When reconstruction is indicated, the surgical approach is planned on the basis of information gained from preoperative angiography and study of ventricular anatomy as defined by magnetic resonance imaging (MRI). At operation, the precise limits of resection are determined in the open beating heart by inspection and palpation. Reasons for choosing this approach are given. Techniques for optimizing size and shape of the residual cavity are described. Technique of septal patch exclusion will be outlined. Additional maneuvers for prevention of ventricular arrhythmias will be discussed. Operative mortality and long term results obtained using this approach are reviewed.

Key Words: ventricular reconstruction • aneurysm repair • septoplasty • linear closure