Results of endoaneurysmorrhaphy: does the location of the aneurysm matter?
Endoaneurysmorrhaphy is mostly performed on anterior-septal left ventricular (LV) aneurysms. It may also be applied to posterior aneurysms, which is technically more challenging. Whether the surgical risk is the same, irrespective of the location of the aneurysm, has not been studied before. We reviewed our experience with 158 patients (62+/-9 years, 72% male) undergoing endoaneurysmorrhaphy. Eleven patients (7%) had posterior LV aneurysms. Perioperative mortality was 5.7%. Of all preoperative and surgical variables tested, the presence of a posterior LV aneurysm (p=0.017), concomitant mitral valve surgery (p=0.008) and duration of extracorporal circulation (p=0.001) were significantly associated with higher perioperative mortality. However, patients with posterior LV aneurysms had more severe heart failure (p=0.0061) and a higher LV end diastolic volume index (138+/-38 vs. 102+/-41 ml/kg body weight; p=0.040) than patients with antero-septal LV aneurysms. Further studies are needed to determine whether the location of the aneurysm is a risk factor for mortality irrespective of the clinical presentation.
Bechtel
J f Matthias
Jf
Department of Cardiac Surgery, University Clinic of Luebeck, Germany. bechtel@medinf.mu-luebeck.de
Tölg
Ralph
R
Robinson
Derek R
DR
Graf
Bernhardt
B
Richardt
Gert
G
Kraatz
Ernst G
EG
Sievers
Hans-Hinrich
HH
Bartels
Claus
C
D000368:Aged; D005112:Extracorporeal Circulation; D005260:Female; D006322:Heart Aneurysm / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications; D012307:Risk Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left