title: [Comparison of early clinical results after left ventricular aneurysmectomy using classic and modified technique].
abstract: 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.
authors.affiliation: Klinika Chirurgii Serca, Naczyń i Transplantologii Instytutu Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. kardiochir@szpitaljp2.krakow.pl
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Sławomir
authors.initials: S
authors.lastname: Wójcik
authors.forename: Bogusław
authors.initials: B
authors.lastname: Kapelak
authors.forename: Krzystof
authors.initials: K
authors.lastname: Wróbel
authors.forename: Jacek
authors.initials: J
authors.lastname: Piatek
authors.forename: Edward
authors.initials: E
authors.lastname: Pietrzyk
authors.forename: Karol
authors.initials: K
authors.lastname: Wierzbicki
authors.forename: Paweł
authors.initials: P
authors.lastname: Moncznik
authors.forename: Marek
authors.initials: M
authors.lastname: Traczyński
mesh_terms: 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