article · SAS Journal of Surgery
Left ventricular aneurysm is a severe complication following myocardial infarction that can occur alongside ischemic mitral regurgitation, exacerbating heart failure. A sixty-four-year-old male presenting with severe dyspnoea was diagnosed with a post-infarction left ventricular aneurysm, three-vessel coronary artery disease with total occlusion of the right coronary artery, severe left ventricular systolic dysfunction with an ejection fraction of 30 percent, and severe ischemic mitral regurgitation. The patient was treated using surgical left ventricular reconstruction combined with complete myocardial revascularisation, deliberately omitting direct mitral valve repair or replacement. Postoperative recovery proceeded without complications, yielding marked clinical improvement alongside the regression of the mitral regurgitation from severe to grade I. The outcome indicates that restoring left ventricular geometry and haemodynamics through ventricular reconstruction and bypass grafting can secondarily resolve functional ischemic mitral regurgitation.
Severe ischemic mitral regurgitation often complicates heart disease after a heart attack, posing difficult surgical choices. Demonstrating that repairing the ventricular aneurysm and restoring blood supply can independently reduce mitral regurgitation may help cardiac surgeons simplify surgical strategies, potentially avoiding the risks associated with additional mitral valve surgery in fragile patients.
As a single clinical case report, this work provides observational evidence relevant to cardiac surgeons and clinical protocol developers rather than a commercial product. The findings represent very early-stage clinical insight into surgical decision-making, showing that ventricular reconstruction can reduce the need for separate valve interventions, but extensive clinical trials would be required before informing standardised surgical guidelines.
AI-generated from the published abstract. Always read the original work before citing.
Left ventricular aneurysm (LVA) is a serious late mechanical complication of myocardial infarction and may be associated with ischemic mitral regurgitation (IMR), leading to or worsening severe left ventricular systolic dysfunction. We report the case of a 64-year-old man with diabetes and active smoking who was admitted with New York Heart Association (NYHA) class IV dyspnea. Transthoracic echocardiography and cardiac magnetic resonance imaging revealed a post-myocardial infarction left ventricular aneurysm, severe systolic dysfunction with a left ventricular ejection fraction of 30%, and severe ischemic mitral regurgitation. Coronary angiography demonstrated three-vessel coronary artery disease with chronic total occlusion of the right coronary artery. The patient underwent complete myocardial revascularization combined with surgical left ventricular reconstruction without mitral valve intervention. The postoperative course was uneventful, with clinical improvement and regression of mitral regurgitation to grade I. This case highlights the potential role of surgical ventricular reconstruction combined with coronary artery bypass grafting in restoring left ventricular geometry and hemodynamics, with secondary improvement of functional ischemic mitral regurgitation.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.36347/sasjs.2026.v12i08.014
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
