A successful treatment of ischemic cardiomyopathy associated with left ventricular aneurysm and chronic ischaemic mitral regurgitation (RCD code: III-1B.9.o).

Klaudia Knap, Leszek Drabik, Justyna Błaut-Jurkowska, Michał Pacia, Maciej Krupiński, Małgorzata Urbańczyk–Zawadzka, Wojciech Płazak

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Abstract


Complications of myocardial infarction (MI) such as left ventricular aneurysm, chronic ischaemic mitral regurgitation (CIMR) and heart failure are associated with a poor prognosis. The management of complex defects is challenging and requires an individualized strategy. We describe a case of 44-year-old male with multiple complications of MI including heart failure with reduced ejection fraction, left ventricular aneurysm and severe CIMR. We present complex approach, aimed at correcting various components of ischemic cardiomyopathy: relieving ischemia, reducing left ventricular wall tension, reducing volume overload and pulmonary hypertension by mitral valve surgery and  left ventricular reconstruction (also known as the Dor procedure). In this case report, we describe the crucial role of echocardiography and magnetic resonance imaging before surgery.


Keywords


chronic ischaemic mitral regurgitation; heart failure; ventricular remodeling; left ventricular aneurysm; mitral valve replacement

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DOI: http://dx.doi.org/10.20418%2Fjrcd.vol3no4.271

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