title: Determinants of long-term survival after ventricular aneurysmectomy.
abstract: To determine the effect of aneurysmectomy solely or combined with direct revascularization, 349 consecutive surgical patients treated between 1962 and 1972 were retrospectively reviewed. The minimum follow-up for survivors was 5 years (mean, 7 years). Single-vessel disease occurred in 171 (49%) and only ventricular aneurysmectomy was performed (Group 1). Multiple-vessel disease was found in 178 (51%), of whom 79 (44%) had resection of a ventricular aneurysm and revascularization of all major obstructed vessels (Group 2); 99 (56%) had aneurysm resection and incomplete revascularization (Group 3). Survival at 7 years was 69% for Group 1, 65% for Group 2, and 51% for Group 3. Actuarial survival at 7 years was 70% for patients operated on for angina; 55% for congestive heart failure; 57% for a combination of angina and heart failure; and 64% for ventricular tachycardia. Survival of patients with multiple-vessel disease who underwent aneurysmectomy and complete revascularization was similar to that of patients with single-vessel disease who underwent aneurysmectomy alone. Longevity is adversely influenced by incomplete revascularization (p less than 0.005) and preoperative congestive heart failure (p less than 0.005).
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000401:mortality; D003327:Coronary Disease / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D013610:Tachycardia / Q000209:etiology / Q000401:mortality