Posterior non-ischemic left ventricular aneurysm. Report of 2 surgical cases.

Posterior non-ischemic left ventricular aneurysms are unusual aneurysms of different etiology that develop adjacent to the mitral valve annulus causing mitral regurgitation and progressive heart failure. Surgical correction is mandatory and involves repair of the aneurysm along with repair or replacement of the mitral valve. Two cases of posterior non-ischemic left ventricular aneurysms are reported. Both patients were females (19 and 9 years old) and they presented with symptoms of progressive heart failure. Definite diagnosis was made with transesophageal echocardiography (TEE) and confirmed with left ventriculography. Both patients were successfully treated by surgery. The first patient underwent repair of the aneurysm from inside the left ventricle and mitral valve replacement. The second patient had resection of the aneurysm through an extracardiac route. Both patients are in NYHA class 1, 5 and 4 years respectively after their operation with no evidence of mitral valve dysfunction. Posterior non-ischemic left ventricular aneurysms can securely be diagnosed by TEE and angiocardiography. Surgical treatment is mandatory in order to forestall potential life threatening cardiovascular events and should be tailored to the operative findings.

Circulatory arrest in a reoperation for brachiocephalic arterial occlusive disease.

We report a patient with multiple brachiocephalic arterial occlusive disease who suffered failure of a bifurcated aorto-carotid artery graft. Profound hypothermic circulatory arrest provided adequate cerebral protection during redo aorto-brachiocephalic arterial grafting.