Surgical management of traumatic left ventricular aneurysm using the Dor technique: a case presentation

Abstract

Abstract Background Left ventricular aneurysms are typically caused by myocardial infarction but can also result from blunt chest trauma, though this is rare. They can lead to complications such as heart failure, arrhythmias, and sudden death. This report aims to highlight the occurrence of left ventricular aneurysms resulting from blunt chest trauma and to demonstrate the efficacy of surgical management using the Dor technique in restoring cardiac function. Case presentation We present the case of a 54-year-old woman with no prior history of cardiovascular issues who developed heart failure at NYHA class III due to a left ventricular aneurysm following blunt chest trauma sustained in a motor vehicle accident. A cardiac echocardiogram revealed a large left ventricular aneurysm with a left ventricular end-diastolic volume of 163.4 mL and an indexed end-diastolic volume of 103.4 mL/m2. A cardiac computed tomography scan confirmed the presence of a left ventricular aneurysm measuring 4.8 cm × 5.5 cm, with no signs of coronary artery disease. The patient underwent surgical resection of the aneurysm and left ventricular reconstruction using the Dor technique, which involves endo-cavitary circular patch repair under cardiopulmonary bypass. The patient was successfully extubated 36 h postoperative, with an uneventful recovery and no reported complications. Postoperatively, the left ventricular diameter returned to near-normal levels and the left ventricular function improved, with the ejection fraction increasing from 40 to 52%. The patient was discharged in stable condition 9 days after the surgery. Seven-month postoperative follow-up showed favorable improvement in clinical symptoms with sinus rhythm, preserved cardiac ejection function, and no recorded complications. Conclusion Left ventricular aneurysms can be caused by blunt chest trauma and should be considered in post-trauma patients, despite their rarity. It is essential to promptly recognize and surgically treat traumatic left ventricular aneurysms to restore cardiac function and prevent further complications. The Dor technique has shown promising results in the surgical management of these aneurysms.

Keywords

• Aneurysm
• Ventricular aneurysm
• Ventricular reconstruction
• Chest trauma
• Dor technique