Surgical management of left ventricular aneurysms.
Criteria to identify the presence or absence of a resectable left ventricular aneurysm at the time of surgery are defined. Hemodynamic compromise resulting from aneurysm formation is discussed. The symptoms and natural history of patients with a left ventricular aneurysm are reviewed, and an argument is made for early aneurysm resection before severe left ventricular distention and decompensation occur. Various repair techniques are reviewed, with special attention given to the modified linear closure technique favored by the author, which allows the entire repair to be completed before aortic cross-clamping, thus keeping ischemic time to a minimum. The influence of aneurysm repair on concomitant mitral regurgitation is discussed. Postoperative complications and early and late results are reviewed. It is concluded that with proper patient selection and improved operating room techniques, ventricular aneurysm resection can be performed with low operative mortality, good symptomatic improvement, and excellent 5-year survival.
Mickleborough
L L
LL
Department of Surgery, University of Toronto, Ontario, Canada.
D017541:Aneurysm, False / Q000601:surgery; D006322:Heart Aneurysm / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles; D006439:Hemodynamics; D006801:Humans; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome