Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography.
Mortality of surgical resection of a left ventricular (LV) aneurysm is largely determined by size and function of nonaneurysmal or residual myocardium. A residual myocardial index was determined using 2-dimensional echocardiography (2-D echo) in 56 consecutive patients scheduled for LV aneurysmectomy, and these results were correlated with surgical outcome. The index was calculated using 3 apical cross sections: the 2- and 4-chamber views and the long-axis view. These views were recorded at mutual angles of 60 degrees. In each view the end-diastolic length of normally moving endocardium of the 2 opposite walls was expressed as a fraction of the end-diastolic LV long axis. The index was assessed by averaging the 6 ratios obtained. In 41 survivors the index ranged from 40 to 71% (mean +/- standard deviation 53 +/- 7.8) and in 15 nonsurvivors from 29 to 67% (mean 38 +/- 8.5, p less than 0.01). With 1 exception, this echocardiographic index sharply separated survivors from nonsurvivors. The lower limit to survive aneurysmectomy was 40%.
D000328:Adult; D000368:Aged; D004452:Echocardiography / Q000379:methods; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D009203:Myocardial Infarction / Q000150:complications; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D013997:Time Factors