Left ventricular aneurysms: the endoventricular circular patch plasty.

The endoventricular circular patch plasty (EVCPP) technique was first used by us in 1984 to re-establish a more normal morphology of the left ventricular cavity distorted by post-myocardial infarction scar tissue. This technique includes the placement of a subendocardial circumferential pursestring suture inside the left ventricle around the base of the aneurysm at the junction of scarred and normal endocardium. A patch is then placed at this level to establish a new contour for the left ventricular cavity. Because this patch is placed at the junction of scar and normal endocardium, a substantial portion of the distal ventricular septum is excluded from the left ventricular cavity. The overall hospital mortality in our series of more than 715 cases is approximately 7% and, in the survivors, the ejection fraction is increased an average of 0.10.