Linear repair versus ventricular reconstruction for treatment of left ventricular aneurysm: a 10-year experience.
OBJECTIVE
To describe a 10-year experience with surgical treatment of left ventricular aneurysm and compare the results of linear repair and ventricular reconstruction.


METHODS
A retrospective data analysis.


METHODS
Department of cardiothoracic surgery.


METHODS
All patients treated with concurrent coronary artery bypass revascularization and surgical repair of ventricular aneurysm from 1985 to 1995.


METHODS
Patients underwent either linear repair after aneurysmectomy (group A; n=51) or reconstruction of the left ventricle using a patch (group B, n=10). Preoperative patient characteristics and postoperative mortality and symptomatic results in the two groups were compared with chi(2) and paired "t"-tests.


RESULTS
The early mortality rates were 9.8% overall, 7.8%, in group A, and 20% in group B. During a mean follow-up of 58 months, the late mortality rates were 34.5%, 38.2%, and 12.5%. In comparison to patients in group A, those in group B had higher preoperative rates of seriously impaired left ventricular ejection fraction (p=0.01) and pathologic left ventricular end-diastolic pressure (p=0.03) and a prolonged operative aortic cross-clamp time (p=0.04). Early mortality in group B may have been influenced by the initially impaired hemodynamic function and the cross-clamp time. In the longterm, patients in group B had more symptomatic improvement than those in group A (p=0.02).


CONCLUSIONS
Ventricular function in patients with left ventricular aneurysm improved after ventricular reconstruction using a patch. Further experience with this procedure should improve postoperative survival and long-term prognosis.
Vicol
C
C
Clinic of Cardiac Surgery, Central Hospital, Augsburg, Germany.
Rupp
G
G
Fischer
S
S
Summer
C
C
Dietrich Bolte
H
H
Struck
E
E
D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D001026:Coronary Artery Bypass; D005260:Female; D006322:Heart Aneurysm / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D016277:Ventricular Function, Left
D011138:Polytetrafluoroethylene