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Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart  Yoshitaka Yamane, MD, Shogo Mukai, MD, Hironobu Morimoto, MD, Hiroshi.

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Presentation on theme: "Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart  Yoshitaka Yamane, MD, Shogo Mukai, MD, Hironobu Morimoto, MD, Hiroshi."— Presentation transcript:

1 Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart 
Yoshitaka Yamane, MD, Shogo Mukai, MD, Hironobu Morimoto, MD, Hiroshi Koshiyama, MD, Shuhei Okubo, MD  The Annals of Thoracic Surgery  Volume 100, Issue 5, Pages (November 2015) DOI: /j.athoracsur Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Left ventriculographic view on arrival. The right anterior oblique view shows a burrow in the inferior wall (white arrow). Extravasation of contrast material into the extracardiac space is not seen. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Transesophageal echocardiography on the next day after AMI. White arrow depicts abrupt interruption of the inferior left ventricular wall leading into a saccular aneurysm through a narrow neck. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Computed tomographic view after 23 days shows expansion of the aneurysm, with the maximal diameter increasing to 30 mm. The walls of the aneurysm are thin and abut on the epicardium. External expansion does not occur. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 (A) Surgical approach. Orifice of the subepicardial aneurysm is located in the lateral proximity of the papillary muscle. (B) Schematic illustration of our surgical approach: 9 mattress sutures of polypropylene felt pledget were passed through the firm myocardial lip, and an appropriate-size bovine pericardial patch was inserted to cover the defect. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

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