[Post-myocardial infarction ventricular aneurysm and intractable ventricular tachycardia supported by left ventricular assist device: a case report].

ABSTRACT

A 57-year-old man was admitted under a diagnosis of myocardial infarction. Cardiac catheterization revealed total occlusions of the right coronary artery and the left anterior descending artery, and ventriculography showed aneurysmal change in the anterior and septal segments. Circulatory support was introduced with intraaortic balloon pumping, but intractable ventricular tachycardia developed. Electrophysiological mapping and cryoablation to the myocardium were performed intraoperatively, and then coronary artery bypass grafting with endoventricular circular patch plasty of the left ventricle was carried out. Weaning from the cardiopulmonary bypass was attempted, but a left ventricular assist device was subsequently implanted to support the deteriorated ventricular function. The hemodynamics of the ventricle improved several days after the circulatory support was introduced, and the left ventricular assist device was removed successfully. This case suggests that the left ventricular assist device is an effective method to support recovery from serious complications after myocardial infarction.