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How you can Repair Ventricular Aneurysm with a patch?
Repair of Ventricular Aneurysm with a patch : Originally described by Cooley, as endoaneurysmorraphy, this has been largely replaced by endovenhicular circular patchplasty repair (Dor) or one of its modifications.
In this technique, dyskinesia or akinesia of anterior pat of ventricular septum are taken care of by sewing in a Dacron patch.
Integral steps of this operation are the same as previously described. After ventricular incision over the anterior part of the ventricular aneulysrn, by palpation, demarcation of normal muscle from the thinned out aneurysm is made out. A purse string suture of 2'0' poly propylene is passed all around and tightened so as to get the ideal vertical and transverse dimensions of the remaining left ventricle. The resulting defect, which is now circular or oval, is repaired using a collagen or gelatin impregnated polyester (Dacron) graft. The inner surface of this graft could be lined with autologus pericardium. In the modified Dor procedure adopted at Narayana Hridayalaya, purse string suture is not used but a correctly measured oval patch of similar graft is used to achieve the correct dimension and geometry of remaining LV. The overlying portion of aneurysm is closed in two layers using polypropylene sutures without pledgets.
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