Three ventriculoplasty techniques - Applied to three left-ventricular pseudoaneurysms in the same patient

A 59-year-old male patient underwent surgery for triple-vessel coronary art ery disease and left-ventricular aneurysm in 1994. Four months after corona ry artery bypass grafting and classical left-ventricular aneurysmectomy (wi th Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyd e-treated pericardium patch over which an omental pedicle graft was placed. Two months later under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later Ster nocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months alter the last surgical interventi on, the patient died of cerebral malignancy Pseudoaneurysm reformation, how ever had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative te chniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscl e flaps be strongly considered as a material for re-repair of left-ventricu lar aneurysms.