title: Repair of left ventricular aneurysm during off-pump coronary artery bypass surgery.
abstract: BACKGROUND
  Acute myocardial infarction can result in left ventricular aneurysm, which may in turn cause congestive heart failure, ventricular arrhythmia and thromboembolic events. This study evaluates results achieved with a modified linear closure of left ventricular aneurysms during off-pump coronary artery bypass surgery.
  
  
  METHODS
  From January 2001 to May 2004, 75 patients were operated on for nonruptured, postinfarctional, left ventricular aneurysm during off-pump coronary artery bypass surgery. Repair was completed on the beating heart to minimize ischaemia and allow assessment of wall function and viability to guide closure. All patients presented with symptoms of angina and congestive heart failure or ventricular arrhythmia. The majority (75%) of the patients were in NYHA functional class III or IV. Preoperative ejection fraction was 26% +/- 9%. The mean left ventricular, end diastolic diameter was (57.5 +/- 7.1) mm. The ventricular preoperative and postoperative performances were compared. chi2 test and Student's t test were used to analyse the outcomes. A P value less than 0.05 was considered significant.
  
  
  RESULTS
  Hospital mortality was 1.3% (1/75). Coronary artery bypass was performed with an average of (3.3 +/- 1.2) grafts per patient. At the time of followup, all the patients had no symptoms. The mean NYHA class and ejection fraction increased significantly (P < 0.001). The mean left ventricular, end diastolic diameter decreased significantly (P < 0.001).
  
  
  CONCLUSIONS
  Surgical closure of left ventricular aneurysm can be performed during off-pump coronary artery bypass. The operation is associated with a low inhospital mortality and morbidity. A postoperative improvement in the early term cardiac functions and symptoms and quality of life was documented, increasing our expectations of an increased long-term survival.
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Science, Beijing 100029, China. dr_yuyang@sohu.com
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Cheng-xiong
authors.initials: CX
authors.lastname: Gu
authors.forename: Hua
authors.initials: H
authors.lastname: Wei
authors.forename: Rui
authors.initials: R
authors.lastname: Liu
authors.forename: Chang-cheng
authors.initials: CC
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005260:Female; D006322:Heart Aneurysm / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left