Left ventricle aneurysm and intra cavity thrombus removal: 55 Years old Patient was admitted to the Saudi German Hospital in Dubai after sudden Heart Attack emergency workup revealed severe multiple coronary arteries disease with Mitral Valve regurgitation and very low Heart function (29%).
He was shifted to us in a very critical condition and was immediately admitted to ICU and prepared for urgent surgery. In the Angiogram the backside heart artery (RCX) was dominant and showing a sub-total occlusion, the right coronary artery (RCA) was totally occluded and the main front artery (LAD) of the heart had 90% stenotic lesion. The Echocardiography was showing a moderate Mitral Valve insufficiency and a closed (not complete) rupture of the free heart wall near to apex with a huge intraventricular thrombus (inside the main left heart chamber). One of the most dangerous complication of a heart infarction is main Heart Chamber muscle rupture (left ventricle) happening in less than 0,5% of acute myocardial infarctions. This can appear as rupture of the wall between both main heart cavities causing a hole inside the heart (post infarction Ventricle septum defect VSD). Also it can appear as rupture of papillary muscles causing severe mitral valve insufficiency. The third rare possibility but the most dangerous one is free wall rupture which causes immediate death.
In our patient the free wall was incompletely ruptured causing a life threatening condition where it is just a matter of short time to complete this rupture. In addition there was a huge thrombus attached to the inside wall of the left main heart chamber with direct contact to blood flow so if any small part of this thrombus moved it will cause severe infarction of any organ especially stroke . The challenge was to fix all these problems in one big heart operation taking into consideration the severe heart muscle weakness. The surgery was done successfully and the patient was discharged from ICU after 4 days and from hospital after 9 days in a good condition.
In the Pictures (video) you will see how we opened the ruptured wall and took out the thrombus from inside the heart. This challenging surgery was performed by Dr. Basem Duwederi (HOD Cardiac Surgery Department) and the distinguished surgical and post-operative team with highest professionalism, allowing the patient to fulfill a normal life after completing his recovery process.