Pushing Surgical Boundaries: 3D Video-Assisted Endoscopic Dor Procedure and MVR for Post-Infarction Huge LV Aneurysm

This video is one of the top 10 entries from the 2025 Endoscopic Cardiac Surgeons Club Video Competition. More videos featuring these outstanding presentations will be showcased in the coming weeks.  

This video shows an endoscopic complex left ventricular post-infarction aneurysm repair with concomitant mitral valve repair. The patient was a 55-year-old male who had 30 percent left ventricular ejection fraction (LVEF) with a chronically occluded circumflex artery. The echocardiogram showed a large left ventricular (LV) aneurysm and mitral regurgitation. The patient was placed on bypass with percutaneous cannulation of the femoral vessels. The aorta was cross-clamped, and the heart was arrested with del Nido cardioplegia. The left ventricle was explored with the 3D endoscope. An exclusion patch technique was used to repair the aneurysm. Sutures with pledgets were placed around the edge of the aneurysm, consisting of 2-0 braided polyester with pledgets. A pericardial patch was secured in place, and Cor-Knots were used to fasten it. Once the aneurysm was repaired, the mitral valve was repaired using a full annuloplasty ring. Postoperatively, the echo showed complete exclusion of the aneurysm and resolution of the regurgitation. The patient was discharged in good condition. 

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