Ventriculoplasty for left ventricular aneurysm
In the long-term course after myocardial infarction, up to 10 percent of survivors develop a left ventricular aneurysm, an enlargement of the scarred left ventricle. The consequences are a loss of the egg-shaped geometry of the left heart with insufficient pumping function, the formation of clots on the inner wall of the heart and life-threatening rhythm disturbances. These patients have an increased risk of mortality of 30-50 percent in the medium term. In the modified ventricular reconstruction according to Dor, the aneurysm sac is removed and the geometry of the left ventricle is reconstructed by implanting an oval plastic patch at the border of healthy to scarred heart muscle tissue.
If indicated, ventricular reconstructive surgery can also be performed as a combined procedure with additional application of aortocoronary bypasses and/or heart valve surgery. The intervention is performed in our experienced hands with low surgical risk. Compared to drug therapy, patients who have undergone surgery benefit from improved exercise tolerance, fewer cardiac arrhythmias and a reduced risk of clot formation.
Mechanical circulatory support
If the heart muscle weakness can no longer be controlled, the patient can be stabilized by a support system mounted outside the body. Pump systems for supporting the left ventricle are nowadays small flow pumps that can be completely implanted except for the supply line.
The therapy of myocardial insufficiency with mechanical circulatory support systems pursues three strategies: support until organ recovery with the possibility of explanting the pump - as a bridge until a donor organ is available at a transplant center or as a final permanent therapy. The therapeutic concept of mechanical circulatory support enables outpatient care for most patients. In the case of bridging to transplantation, close cooperation with a transplant centre is already guaranteed as before.