Natural history of surgically treated ventricular aneurysm.
Forty-one patients underwent resection of a postinfarction ventricular aneurysm. Thirty-seven of them had associated saphenous vein grafting procedures (average, 2.3 grafts per patient). Thirty-five patients sustained left ventricular dysfunction preoperatively. Forty patients were followed until death or for a minimum of five years (1 was lost to follow-up), and functional status was evaluated. Hospital mortality was 12%. Twenty-four patients survived five years or longer, and 20 patients were alive after a mean follow-up of 84 months. Eighty percent of the nonsurvivors died of atherosclerosis-related events. Forty-nine percent of the patients who survived the operation sustained severe atherosclerotic events postoperatively. Only 2 of 15 nonsurvivors ever regained functional status as judged by return to work. Twelve of the 20 long-term survivors returned to work. Of those patients less than 50 years old at operation, only 17% returned to work. Preoperative left ventricular function was a significant predictor of long-term functional results of aneurysmectomy and saphenous vein grafting. All patients remained at high risk for continued events related to atherosclerotic cardiovascular disease, and only 37% returned to full-time, preoperative work status. Return to productive status was especially disappointing in patients less than 50 years old.
D000328:Adult; D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000150:complications; D004630:Emergencies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011183:Postoperative Complications; D012306:Risk; D012501:Saphenous Vein / Q000637:transplantation; D014937:Work