[Surgical treatment of aneurysms of the left ventricle. Immediate and long-term results. Apropos of a consecutive series of 121 cases].
From 1978 to 1992, 121 cases of postinfarction left ventricular aneurysm (99 males, 22 females, mean age 60 years) were operated on. The authors insist on a high rate of clinical arhythmogenicity (31.4%) and associated mechanical complications (21%). 76% of patients were in functional NYHA class III or IV. Resection was performed in 90% of patients, plication in 10%. 58% underwent coronary artery bypass grafting (1.7 graft/patient), 16% encircling ventriculotomy, 8% mitral valve replacement and 13% closure of ventricular septal defect. Operative mortality was 14.9% (10% when other mechanical complications where excluded). 5-year survival is 67.9%. Late cardiac deaths are as follow: left ventricular failure (1.8% A/P), Sudden death (1.4% A/P), Myocardial infarction (0.6% A/P). 82% of survivals are in functional NYHA class I or II. Only functional class NYHA III or IV is predictive of late death. We conclude that postinfarction left ventricular aneurysm remains a high risk complication especially when associated with other mechanical complications. When arhythmogenicity is present we suggest rhythmologic surgery and in all cases, complete revascularization.
Valla
J
J
Clinique Chirurgicale Cardiovasculaire et Thoracique, CHU, Rennes.
Leguerrier
A
A
Corbineau
H
H
Sevray
B
B
Langanay
T
T
Le Couls
H
H
Sellin
M
M
Rioux
C
C
Logeais
Y
Y
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D009204:Myocardial Revascularization
Traitement chirurgical des anévrysmes du ventricule gauche. Résultats immédiats et éloignés. A propos d'une série consécutive de 121 cas.