Abstract
Despite the great success of modern methods of treating coronary artery disease, it still remains one of the most widespread disease. Disability occurs as a result of the formation of large-focal myocardial infarction and its complications. One of the complications is a postinfarction left ventricular aneurysm, which is formed as a result of a complex cascade of events leading to cardiac remodeling, namely, disruption of the normal geometry of the left ventricle (LV). Clinically manifested by the development of heart failure (HF), which leads to a significant decrease in the quality of life. In most cases, drug therapy for postinfarction heart failure is ineffective. The very presence of an aneurysm with an appropriate HF clinic is an indication for open-heart surgery – reconstruction of the left ventricle. The evolution of reconstruction methods has come a long way. The modern stage in the treatment of left ventricular aneurysm began in 1958, when D. Cooley, for the first time performed LV aneurysm resection using the linear plasty. A revolution in LV aneurysm surgery was the operation of geometric LV reconstruction using a patch, performed by V. Dor in 1989. Since then, many new treatment methods have appeared, but the results remain suboptimal. A significant proportion of patients remain with heart failure after surgery. Many patients need to require circulatory support, hospital mortality is 6–8%. LV remodeling is accompanied by distortion and displacement of the papillary muscles and in many cases leads to ischemic mitral insufficiency, which significantly reduces the likelihood of a favorable outcome. In some cases, moderate mitral regurgitation is reduced after LV reconstruction – the restoration of normal geometry. However, often, uncorrected mitral regurgitation can progress and cause acute heart failure in the postoperative period.
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About the authors
- Leo A. Bockeria, Academician of the Russian Academy of Sciences; ORCID
- Magomed N. Abzhuriev, Postgraduate; ORCID
