Plastics of the left ventricle aneurysm with minimally invasive multivessel coronary artery bypass grafting

The left ventricular aneurysm plastics through left thoracotomy without cardiopulmonary bypass was first described by Likoff and Bailey. Cooley published the first experience of the left ventricular aneurysm repair using cardiopulmonary bypass in 1958. Nowadays, the generally accepted technique of the left ventricular aneurysm plastic involves cardiopulmonary bypass and access through the median sternotomy. In our clinics, the technique of minimally invasive coronary artery bypass grafting has been developed and implemented into the routine practice. The technique allows complete revascularization of the myocardium, regardless of the number of shunts, the quality of the coronary arteries, the left ventricular ejection fraction and the age of the patient. The article describes two clinical cases of the left ventricular aneurysm repair during minimally invasive multivessel coronary artery bypass through the left anterolateral thoracotomy. The access through the left anterior thoracotomy in the fourth intercostal space provides necessary visualization of the left anterior descending artery in all distance, that prompted us to make plastic of the left ventricle aneurysm under the same access feasible. On the decompressed heart, the aneurysm is clearly visualized. This technique might be safely and effectively used in the cases of surgical treatment of the coronary heart disease complicated by postinfarction left ventricular aneurysm. This makes possible to broaden the horizons of minimally invasive multivessel coronary artery bypass grafting usage in complications of the myocardial infarction.