Abstract
Cardiac CT for Assessment of Myocardial Geometry before and after Surgical Repair of Apical Left Ventricular Aneurysm
Highlights
Myocardial infarction can lead to scarring of affected myocardial segments with subsequent development of an aneurysm[1]
The multislice computed tomography (MSCT) data of 35 patients (30 men, 5 women) ranging in age from 27 – 87 years who underwent left ventricular restoration during the study period were included in the analysis
left ventricular (LV)-ESV decreased from a mean of 228.44 ± 117.97 ml/m2 preoperatively to a mean of 135.33 ± 79.89 ml/m2 postoperatively, while left-ventricular volume decreased from a median of 310.44 ± 122.2 mL/m2 during diastole (LV-ESV) to a mean of 200.94 ± 83.87 ml/m2 (Table 1)
Summary
Myocardial infarction can lead to scarring of affected myocardial segments with subsequent development of an aneurysm[1]. Enlargement and abnormal configuration of the ventricle results in dilatation of initially unaffected myocardial segments with markedly reduced pump function. Many of these patients will develop cardiac insufficiency[3,4]. Traditional treatment with ACE inhibitors[5] often turns out to be inadequate in patients with left ventricular (LV) aneurysm These patients can undergo surgical repair of the ventricle[6]. LV reconstruction according to Dor has become the established surgical approach[7] and aims at restoring the normal elliptical configuration of the ventricle This in turn will normalize ventricular volume loading, thereby preventing remodeling and reducing wall tension. Echocardiography and magnetic resonance imaging (MRI) have become the gold standard of cardiac imaging for diagnostic assessment and treatment planning[9] while dual-source computed tomography (CT) enables efficient evaluation of cardiac morphology[10]
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