Geometric reconstruction in left ventricular aneurysm. Surgical aspects and early results.
The early results of 79 patients who underwent left ventricular aneurysmectomy with geometric and circular reconstruction in a seven-year experience are analyzed. The most common indication for operation was congestive heart failure (78.4%), either isolated (25.3%) or with angina (53.1%). Sixty patients (76%) were in NYHA class III and 10 (12.6%) in NYHA class IV at the time of surgery. Fifty-eight (73.4%) underwent coronary artery by-pass graft surgery. Hospital mortality was 5.1%, in patients older than 60 (12%), in NYHA class IV (20%), with poor left ventricular function (EF < 0.30-20% and LVED > 25) (14%), and with extensive coronary artery disease (10%) were under increased risk. Low cardiac output and use of intra-aortic balloon pump were also associated risk factors. Other risk factors mentioned in the literature are discussed. There were no deaths from isolated left ventricular aneurysmectomy. The early results of this study and the early and late results of others using the same technique are better than the results obtained in previous studies of different types of correction, suggesting that this is the procedure of choice for treating left ventricular aneurysm.
Stolf
N A
NA
Surgical Department, Hospital Beneficiencia, Portuguesa, Sao Paulo SP, Brazil.
Erdman
S
S
Santos
G
G
Haddad
V
V
Simoes
R
R
D000328:Adult; D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications; D005069:Evaluation Studies as Topic; D005260:Female; D006322:Heart Aneurysm / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications