Left Ventricular Aneurysm Repair for the Management of Left Ventricular Dysfunction

Although left ventricular aneurysms had previously been described by Hunter and others through their autopsy work it was not until the 1880s that aneurysms were proposed to occur as the result of coronary artery stenosis.1 The relationship between myocardial infarction, fibrosis and aneurysm formation and coronary artery disease was first recognized at that time. Likely Beck was the first to attempt the repair of a post-infarction left ventricular aneurysm when in 1944 he reinforced the ventricular wall with fascia lata.2 Likoff and Bailey followed in 1955 by resecting an aneurysm without cardiopulmonary bypass using a specially designed side-biting left ventricular clamp that could be applied through a thoracotomy incision.3 Subsequently, in 1958 Cooley reported the first successful open repair of a left ventricular aneurysm using cardioplumonary bypass and a buttressed linear closure.4 The surgical repair of left ventricular aneurysms has since evolved to address such issues as left ventricular geometry and ventricular arrhythmias.5-8