Results of post-infarction left ventricular aneurysms surgical planning using magnetic resonance imaging and three-dimensional modeling

Author:

Kushnarev S. V.1ORCID,Zheleznyak I. S.1ORCID,Kravchuk V. N.2ORCID,Rud S. D.1ORCID,Shirshin A. V.3ORCID,Menkov I. A.1ORCID

Affiliation:

1. Military Medical Academy named after C.M. Kirov

2. Military Medical Academy named after C.M. Kirov; North-Western State Medical University named after I.I. Mechnikov

3. Military Medical Academy named after C.M. Kirov; ITMO University

Abstract

Aim. To evaluate the results of surgical intervention planning using three-dimensional models based on magnetic resonance imaging in patients with postinfarction left ventricular aneurysms.Material and Methods. Two groups of patients with postinfarction left ventricular aneurysm (PLVA) were included in the study, totaling 41 patients. The first (experimental) group included 17 patients diagnosed with PLVA by magnetic resonance imaging (MRI), and surgical intervention planning was performed using a 3D model of the heart. The control group comprised 24 patients in whom PLVA was diagnosed by echocardiography (TTE) or ventriculography, and surgical intervention planning was performed using traditional two-dimensional slice images.Results. Comparison of full perfusion under cardiopulmonary bypass (CPB) showed statistically significant differences between the groups: this parameter was 60 [56; 68] min in group 1 vs. 71 [61; 84] min in group 2, which was significantly higher (p = 0.043). There were no significant differences in total operation time (280 [265; 320] min in group 1 vs. 263 [248; 283] min in group 2, p = 0.055), overall CPB time (93 [86; 109] min in group 1 vs. 104 [83; 109] min in group 2, p = 0.653), and partial CPB time (31 [26; 39] min in group 1 vs. 27 [21; 32] min in group 2, p = 0.127).Conclusion. The use of 3D models to support surgeons for PLVA correction makes it possible to determine the type of reconstructive surgery, practice the main stages of the upcoming intervention, and reduce the time of full perfusion under CPB during its implementation. 

Publisher

Cardiology Research Institute

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