A CASE OF LEFT VENTRICULAR ANEURYSMAL CHANGE AFTER REPAIR OF A CARDIAC STAB WOUND

Abstract

The patient, a 25-year-old man, had received a stab wound to the left anterior chest with a kitchen knife and was transported to our center. As plane chest roentgenography showed left hemothorax and his blood pressure was decreased, thoracotomy was urgently carried out. An approximatoly 3cm stab wound was recognized on the left side of the anterior descending branch of the left coronary artery, and hemostasis was performed by 4-acus interrupted suture using 3-0 Ticron® thread. Although the postoperative blood circulation was stable, ECG and enzymological examination showed suspicion of myocardial infarction and coronary arteriography showed occlusion of the anterior descending branch of the left coronary artery. Furthermore, left ventricular arteriography showed anteroseptal dyskinesis and ventricular aneurysmal changes. The patient is uneventfully under observation of the course. In the present case, the thrombotic occlusion and so on, which were caused by direct ligation of the coronary artery with suture thread or distortion or flexion of the coronary artery with ligature were considered to be the cause of ventricular aneurysm formation. With regard to the indication for surgery, the procedure for ventricular aneurysm after myocardial infarction is though to be applied to this case.