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Endoventricular Left Ventriculoplasty: Overlap Technique for Akinetic Scar

Division of Thoracic Surgery Komaki City Hospital Aichi, Japan 1 Department of Surgery Nagoya 1st Red Cross Hospital Nagoya, Japan

For reprint information contact: Masaru Sawazaki, MD Tel: 81 568 76 4131 Fax: 81 568 76 4145 email: sawamasa{at}lemon.plala.or.jp Division of Thoracic Surgery, Komaki City Hospital, 1-20 Jhobushi Komaki-city, Aichi 485-0044, Japan.

Four patients were treated by endoventricular left ventriculoplasty with coronary artery bypass grafting. Three were elective cases and one had acute myocardial infarction. The overlap technique of left ventriculoplasty was employed in the 3 elective cases. An endoventricular circular suture was placed on the perimeter of the scar, the lateral free margin of the incision was sutured to the septum directly, and the margin of the septal side overlapped the anterior wall. In these 3 cases, end-diastolic volume index and end-systolic volume index were decreased and ejection fraction was increased postoperatively. It was concluded that coronary grafting combined with left ventriculoplasty using the overlap method was suitable for patients with ischemic heart disease and an akinetic scar.