Endocardial linear infarct exclusion technique for infarcted lateral wall.

We report a novel method of surgical ventricular restoration for an infarcted lateral wall: the endocardial linear infarct exclusion technique. First, transmural ventriculotomy is performed at the centre of the scar longitudinally along the coronary artery. Second, the inner layer is sutured in a longitudinal direction with 4-0 polypropylene continuous sutures to approximate the border between the normal and infarcted myocardium. Finally, the outer layer is closed with a combination of interrupted buttress and continuous over-and-over sutures with outer felt reinforcement. The advantages of endocardial linear infarct exclusion technique are as follows: the risk of bleeding is low; it is not technically demanding and is reproducible; the coronary artery can be preserved; approximation of the base of the anterior and posterior papillary muscles is possible in the case of ischaemic mitral regurgitation and it can also be applied to the anterior and inferior walls.