Surgical Reconstruction of Left Ventricular Aneurysm in Infants. Description of Clinical Cases

Highlights The article presents a positive experience of surgical treatment of iatrogenic aneurysms of the left ventricle in two young children with a long-term follow-up period of up to 2.5 years. Abstract Left ventricular aneurysms are a rare but potentially dangerous pathology in children. Unlike adults, in whom myocardial infarction is the most common cause of LV aneurysm development, in children it is more often a consequence of traumatic damage to LV myocardium. Currently, there are no generally accepted approaches and recommendations for optimal management of such patients. The approach to managing children with this pathology is individual and depends on the overall clinical picture and the presence of concomitant conditions. Surgical reconstruction of a left ventricular aneurysm is associated with high risks of postoperative complications. This article describes two clinical cases. The first patient is a 1 year and 8 months old child undergoing resection of the aneurysmal sac and reconstruction of VSD with LV wall patching. After 30 months of follow-up, the preservation of the geometry and pumping function of the systemic ventricle of the heart was noted. The second patient is a 5 months old child undergoing LV reconstruction (Jatene technique). Normalization of geometry and restoration of LV contractile function remained throughout a follow-up period of 4.5 months. The results obtained, despite the length and severity of the postoperative period, are encouraging.