Surgical treatment of post-infarction left ventricular pseudoaneurysm: a two-decade experience.
Herein, we present a retrospective analysis of our experience with acquired pseudoaneurysms of the left ventricle over a 20-year period.From February 1985 through September 2004, 14 patients underwent operation for left ventricular pseudoaneurysm in our clinic. All pseudoaneurysms (12 chronic, 2 acute) were caused by myocardial infarction. The mean interval between myocardial infarction and diagnosis of pseudoaneurysm was 7 months (range, 1-11 mo). The pseudoaneurysm was located in the inferior or posterolateral wall in 11 of 14 patients (78.6%). In all patients, the pseudoaneurysm was resected and the ventricular wall defect was closed with direct suture (6 patients) or a patch (8 patients). Most patients had 3-vessel coronary artery disease. Coronary artery bypass grafting was performed in all patients. Five patients died (postoperative mortality rate, 35.7%) after repair of a pseudoaneurysm (post-infarction, 2 patients; chronic, 3 patients). Two patients died during follow-up (median, 42 mo), due to cancer in 1 patient and sudden death in the other. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients. Surgical repair is warranted particularly in cases of large or expanding pseudoaneurysms because of the propensity for fatal rupture.
Eren
Ercan
E
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, 34718 Istanbul, Turkey. erenerus@yahoo.com
Bozbuga
Nilgun
N
Toker
Mehmet Erdem
ME
Keles
Cuneyt
C
Rabus
Murat Bulent
MB
Yildirim
Ozgur
O
Guler
Mustafa
M
Balkanay
Mehmet
M
Isik
Omer
O
Yakut
Cevat
C
D000368:Aged; D017541:Aneurysm, False / Q000209:etiology* / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000209:etiology* / Q000601:surgery*; D006342:Heart Rupture, Post-Infarction / Q000517:prevention & control; D006352:Heart Ventricles / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D016019:Survival Analysis; D013536:Suture Techniques; D016896:Treatment Outcome; D014421:Turkey