[Early and late results of the surgical treatment of left ventricular aneurysms; report of 105 patients].
This study determined perioperative mortality and morbidity and attempted to identify predictors of operative mortality and long-term outcome in a series of 105 patients who underwent surgery for left ventricular aneurysm at this institution during a 7-year period. The main indications for treatment of ventricular aneurysm were angina, dyspnea, ventricular arrhythmias and systemic embolism. Overall mortality was 5.7% and 5-year survival 78%. Left ventricular systolic function, age, unstable angina and previous cardiac surgery were independent predictors of operative mortality and of long-term survival. Main complications observed were perioperative myocardial infarction, ventricular tachyarrhythmias and neurological, almost reversible defects. Although our experience with newer techniques such as patch plasty has been acquired in recent years, according to the literature the type of aneurysm repair seems not to be a strong predicator of operative mortality or improved long-term survival. Echocardiography provides important information concerning the extent of tissue resection needed and the ideal size of the patch. In patients with symptomatic coronary disease, complete revascularization should be attempted to allow recovery of adjacent myocardium after restoration of ventricular geometry. Repair of left ventricular aneurysm can be performed with acceptably low mortality by linear closure or by patch plasty technique. Remodelling the left ventricle using an endocardial patch has been found to fulfill its theoretical advantages in improving ventricular performance, by restoring the functional geometry of the heart. This operation can be performed with low perioperative risk and leads to a late functional improvement in the majority of patients.
Carrel
T
T
Klinik für Herz- und Gefässchirurgie, Departement Chirurgie, Universitätsspital Zürich.
Metzger
D
D
Jenni
R
R
Turina
M
M
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000401:mortality; D003952:Diagnostic Imaging; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis
Früh- und Spätresultate der chirurgischen Behandlung von linksventrikulären Aneurysmen: Bericht über 105 Patienten.