“Thumbnail Patch” Endoaneurysmorrhaphy Technique: Essentials for Modified Circular Repair of Left Ventricular Aneurysm

Among the various repair methods proposed for left ventricular aneurysms, those that use a patch sutured along a circular line are the most popular. Many variants have been developed, but our “thumbnail” circular patch endoaneurysmorrhaphy technique incorporates refinements for optimum restoration of the distorted geometry and size, including the use of a significantly smaller patch, strict adherence to the fibrotic transitional border regardless of its depth, and deliberate spatial arrangement of the patch. These refinements minimize stress on the suture line and optimize ventricular remodeling. This paper provides a comprehensive visual and textual explanation of these essential surgical steps.