Left Ventricular Aneurysmectomy and Repair of Post-infarct Ventricular Septal Defect with Concomitant Aortocoronary Bypass Grafting: A Video Presentation

Mechanical complications resulting from myocardial infarction usually have profound acute or chronic hemodynamic effects. Left ventricular aneurysm formation and ventricular septal rupture occurs in 10-20% patients after acute myocardial infarction [1-6]. Surgical techniques have gradually evolved since the first successful operation for post-infarct ventricular septal defect was performed by Cooley and colleagues in 1956 [2,3,6].

Ruptured saphenous vein graft aneurysm after aortocoronary bypass grafting

Computed tomography demonstrated a giant saphenous vein graft aneurysm that compressed the right atrium of a 72-year-old woman 20 years after undergoing coronary artery bypass grafting. Angiography revealed contrast medium leakage in the mid-portion of the graft aneurysm. Aneurysmectomy was performed without repeat grafting. Postoperative myocardial scintigraphy demonstrated no significant myocardial ischemia. The ischemic effect of non-revascularization should be considered preoperatively because of the difficulties with repeat grafting.