[Left ventricular aneurysmectomy with geometric reconstruction].
OBJECTIVE
To summarize the experience in performing left ventricular aneurysmectomy (LVA) with geometric reconstruction and concomitant coronary artery bypass grafting (CABG) without mortality.


METHODS
Forty-two patients underwent LVA with geometric reconstruction and concomitant CABG. Forty-one patients were male, one was female with mean age of (55.5 +/- 2.4) years (40 - 68 years). Preoperative cardiac function was NYHA class III in 32 patients and class IV in 10. Thirty-eight patients had unstable angina pectoris and 10 had the history of severe ventricular arrythmia. Eight patients had ventricular tachycardia. Preoperative left ventricular ejection fraction (LVEF) was 41% (17% - 63%), LVEF was less than 40% in 29 cases. Left ventricular anatomic aneurysms were confirmed by ventriculography. Thirty-three cases underwent Jatene technique; 8 cases, Dor technique, and 1 case, Cooley technique. Mural thrombi were found in 21 patients and were completely removed. CABG was concomitantly performed in all patients. All of the left anterior descending artery was bypassed with left internal mammary artery and the other target vessels with saphenous vein. Mean cardiopulmonary bypass time was (135 +/- 11) minutes and aortic clamping time was (78 +/- 10) minutes.


RESULTS
No hospital mortality occurred and all patients were discharged. Postoperative reexploration for bleeding in 1 patient. The diameter and end systolic and diastolic volume of left ventricle were significantly decreased to nearly normal after operation. Operative ejection fraction had a tendency to increase but without significance (P > 0.05).


CONCLUSIONS
LVA with geometric reconstruction and concomitant CABG could not only improve heart function but also eliminate ventricular arrythmia. The clinical result was excellent.
Gao
Chang-qing
CQ
Department of Cardiovascular Surgery, General Hospital of People's Liberation Army, Institute of Cardiac Surgery of People's Liberation, Beijing 100853, China.
Li
Bo-jun
BJ
Xiao
Cang-song
CS
Zhu
Lang-biao
LB
Wang
Gang
G
Wu
Yang
Y
Ma
Xiao-hui
XH
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D001026:Coronary Artery Bypass; D005260:Female; D006322:Heart Aneurysm / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016277:Ventricular Function, Left