Key result
Aneurysmectomy with patch repair and papillary muscle approximation improved LVEF from 25% to 45% and reduced severe mitral regurgitation to trace levels without direct mitral valve intervention.
Case Report (n=1)
Geometric restoration via aneurysmectomy and papillary muscle approximation can effectively treat severe ischemic mitral regurgitation without direct intervention on the mitral valve.
Supports surgical feasibility in giant LV aneurysm with thrombus; leaves open need for prospective data on outcomes and selection.
A 44-year-old gentleman presented with severe ischemic cardiomyopathy and mitral regurgitation post-inferior myocardial infarction. Echocardiography and magnetic resonance imaging revealed a dilated left ventricle with a large left ventricular aneurysm (9.3 × 9.5 cm) and associated thrombus. Severe mitral regurgitation due to leaflet tethering and a left ventricular ejection fraction (LVEF) of 25% were also seen. The patient underwent successful aneurysmectomy with patch repair and papillary muscle approximation. Following initial weaning from cardiopulmonary bypass, 6 days of postoperative temporary veno-arterial extracorporeal membrane oxygenation support were required. The patient was subsequently discharged on postoperative day sixteen with improved cardiac function (LVEF of 45%) and trace residual mitral regurgitation, highlighting the efficacy of geometric restoration in addressing such mitral regurgitation, avoiding conventional intervention on the mitral valve itself.
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Sitaranjan et al. (2024) conducted a case report in Severe ischemic cardiomyopathy and mitral regurgitation (n=1). Aneurysmectomy with patch repair and papillary muscle approximation was evaluated on Cardiac function and mitral regurgitation severity. Aneurysmectomy with patch repair and papillary muscle approximation improved LVEF from 25% to 45% and reduced severe mitral regurgitation to trace levels without direct mitral valve intervention.
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