[Comparison of early clinical results after left ventricular aneurysmectomy using classic and modified technique].
BACKGROUND
In our department left ventricular aneurysmectomy was performed using only classic Cooley technique until 1989. Since then a modified technique was introduced: left ventricular geometry reconstruction modo Stoney simultaneously with the excision of scarred endocardium.


OBJECTIVE
Comparison of early clinical results after left ventricular aneurysmectomy using classic (Group A) and modified technique (Group B).


METHODS
Retrospective data analysis of early clinical outcome of patients (pts) operated from 1989 to 2000: classic technique 74 pts [63M (85.1%); 11F (14.9%); average age 52.26 +/- 10.35 years], modified technique 86 pts [74M (86%); 12F (14%); average age 55.83 +/- 9.3].


RESULTS
No statistically significant differences between groups considering number of critically stenosed coronary arteries, left ventricular ejection fraction and left ventricular diameters were observed. Mean number of bypass grafts (gr. A 1.55, gr. B 1.69); aortic crossclamping time (gr. A 48.1 (24-77) +/- 12.9; gr. B 50.9 (0-91) +/- 16.1) were not significantly different between groups. In gr. A, 11 (14.8%) pts died: low output syndrome (LOS) 3 pts, LOS and ventricular dysrhythmias (VD) 5 pts, VD 3 pts. In gr. B 4 (4.6%) pts died: LOS 3 pts; LOS and VD 1 pt. Among other complications LOS and VD occurred significantly more frequently in gr. A. In both groups average postoperative ejection fraction increased; twice higher in gr. B than A.


CONCLUSIONS
Modified technique: 1. Significantly decreases incidence of ventricular dysrhythmias in comparison to classic technique. 2. Significantly lowers incidence of low output syndrome and mortality rates in comparison to classic technique.
Sadowski
Jerzy
J
Klinika Chirurgii Serca, Naczyń i Transplantologii Instytutu Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. kardiochir@szpitaljp2.krakow.pl
Wójcik
Sławomir
S
Kapelak
Bogusław
B
Wróbel
Krzystof
K
Piatek
Jacek
J
Pietrzyk
Edward
E
Wierzbicki
Karol
K
Moncznik
Paweł
P
Traczyński
Marek
M
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006322:Heart Aneurysm / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis