title: Left ventricular aneurysm repair with myocardial revascularization: an analysis of 246 consecutive patients over 15 years.
abstract: From 1970 to 1985, 246 consecutive patients with left ventricular (LV) aneurysm underwent repair and concomitant myocardial revascularization at Ochsner Foundation Hospital. The overall incidence of perioperative death was 7.3%. Although the deaths were mainly cardiac related (10/18) with congestive heart failure (CHF) as the leading cause (6/10), 8 deaths were of noncardiac origin. Perioperative mortality increased significantly in patients with mitral regurgitation (MR) (22%; p = 0.0008); perioperative mortality for patients without MR was 4.8%. The overall 5-year survival was 69%. Late deaths were caused most commonly by myocardial infarction (20/32) with only 7 due to CHF. Predictors of long-term survival were related to LV function preoperatively: absence of CHF (p = 0.001); LV end-diastolic pressure less than or equal to 20 mm Hg (p = 0.03); and ejection fraction greater than or equal to 35% (p = 0.02). Factors that did not significantly affect long-term survival were type of aneurysm repair (resection or plication), morphology of left anterior descending coronary artery (occlusion or stenosis), and size of the aneurysm.
authors: Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
authors: J N
authors: JN
authors: Vauthey
authors: D W
authors: DW
authors: Berry
authors: D W
authors: DW
authors: Snyder
authors: J C
authors: JC
authors: Gilmore
authors: K
authors: K
authors: Sundgaard-Riise
authors: N L
authors: NL
authors: Mills
authors: J L
authors: JL
authors: Ochsner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000628:therapy; D003327:Coronary Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006322:Heart Aneurysm / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy; D013997:Time Factors