Results of surgical therapy in patients with left ventricular aneurysm.
The clinical, angiographic and haemodynamic findings in 87 patients with left ventricular aneurysm were investigated before and after different surgical interventions. Thirty-four patients underwent aneurysmectomy alone (group I), 35 patients had additional coronary revascularization (group II), and 18 patients had revascularization alone because of the findings during operation (group III). The size of aneurysm was not significantly different in the three groups. Postoperatively, it decreased only in groups I and II. The majority of the patients in group I (predominantly one-vessel disease) had no angina pectoris, with no significant change early and late (more than 12 months) after operation. The patients in groups II and III (with more two- and three-vessel diseases) showed an improvement in angina pectoris. Preoperatively, most patients had experienced exertional dyspnoea. Overall, there was no significant change after operation, but most patients showed an improvement in angina and dyspnoea when these symptoms had been the major indication for surgical therapy. Heart rate, systolic and end-diastolic pressures in the three groups did not change significantly after surgery. End-diastolic and end-systolic volumes decreased and ejection fraction increased significantly in groups I and II. In group III these variables did not change. Circumferential fibre shortening velocity in the residual ventricle increased significantly only in group I. Haemodynamic studies during exercise were performed in a total of 32 patients. In group I the increase of mean pulmonary pressure was significantly lower postoperatively; there was no significant change in groups II and III.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D000792:Angiography; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care