[Intermediate term clinical results after endoaneurysmorrhaphy in left ventricular aneurysm].
Endoaneurysmorrhaphy (EAR) in postinfarct ventricular aneurysms leads to excellent short-term results. However, the temporal response of EAR is widely unknown. Thus, the indication for surgical treatment of patients with ventricular aneurysms is not well defined. EAR was performed in 157 patients (6/1993-6/1999) with symptomatic ventricular aneurysms (median NYHA III). Factors influencing cardiac mortality and morbidity during follow-up were determined by univariate and multivariate analysis. Perioperative mortality was low: 5%. Mortality during follow-up was 3.3% per year, resulting in a 5-year survival rate of 78%. NYHA classification ameliorated significantly from the preoperative status compared to the follow-up period (median NYHA II; p < 0.001). Multivariate analysis identified preexisting arterial occlusive disease and advanced age (> 70 years) as significant factors influencing medium-term mortality. Implantation of the left internal mammary artery was associated with a better survival rate. Endoaneurysmorrhaphy can be performed with low perioperative mortality, will result in a significant amelioration of the cardiac clinical status and offers low medium-term mortality. Our data indicate that EAR seems to be the procedure of choice for patients with symptomatic ventricular aneurysms.
Bartels
C
C
Klinik für Herzchirurgie Universitätsklinikum Lübeck. sievers@medinf.mu-luebeck.de
Bechtel
J F
JF
Tölg
R
R
Graf
B
B
Walenda
C
C
Leyh
R
R
Nötzold
A
A
Richardt
G
G
Sievers
H H
HH
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D011859:Radiography; D015996:Survival Rate; D013536:Suture Techniques; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*