title: [Surgical treatment of post-infarction left ventricular aneurysm: clinical analysis].
abstract: OBJECTIVE
  To explore the clinical experiences, efficacies and postoperative left ventricular remodeling changes of surgical ventricular reconstruction in the treatment of post-infarction left ventricular aneurysm.
  
  
  METHODS
  The investigators reviewed retrospectively the clinical data, operative approaches and follow-up outcomes of consecutive 194 patients with post-infarction left ventricular aneurysm, who underwent surgical ventricular reconstruction between January 1997 and December 2009. There were 54 cases in the linear group and 137 cases in the endoventricular patch plasty group. The changes of ventricular remodeling were measured by peri-operative and follow-up echocardiography.
  
  
  RESULTS
  All patients underwent surgery with a mean cardiopulmonary bypass duration of (103 ± 35) min and aortic cross clamp duration of (62 ± 26) min. There were 8 per-operative deaths with a mortality rate of 2.2%. Angina pectoris of other cases disappeared and heart function greatly improved. After operation, the ventricular remodeling results showed that in the linear group, there was not significant difference in the changes of ventricular remodeling of post-op 2 weeks, 6 months, 1 year and 5 years versus pre-operation. However, in the endoventricular patch group, the changes of ventricular remodeling of post-op 2 weeks and follow-up 6 months versus pre-operation were significantly reduced (P < 0.05). End-systolic volume (LVESV) reduced from (129 ± 27) ml to (65 ± 8) ml and end-systolic volume index (LVESVI) decreased from (104 ± 14) ml/m(2) to (44 ± 6) ml/m(2) and the subgroup of LVEF < 35% was the most significant in the changes of LVESV and LVESVI. But LVEF improved significantly at post-operation and follow-up (from preoperation 42% ± 11% to 52% ± 7% during follow-up).
  
  
  CONCLUSIONS
  For patients with infarction left ventricular aneurysm, left ventricular reconstruction is quite effective. The choice of operative approaches is determined by the size and range of ventricular aneurysm. Both string suture and endoventricular patch plasty technique can yield similarly satisfactory surgical outcomes. After operation, ventricular volume significantly decreases and cardiac function greatly improves.
authors.affiliation: Nanjing First Affiliated Hospital, Nanjing Medical University, Nanjing Heart Institute, Nanjing 210006, China. stevecx@sina.com
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Zhi-Bing
authors.initials: ZB
authors.lastname: Qiu
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.forename: Ying-Shuo
authors.initials: YS
authors.lastname: Jiang
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Shi
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Mu
authors.forename: Xu-Jun
authors.initials: XJ
authors.lastname: Chen
authors.forename: Fu-Hua
authors.initials: FH
authors.lastname: Huang
authors.forename: Li-Qiong
authors.initials: LQ
authors.lastname: Xiao
authors.forename: Pei-Sheng
authors.initials: PS
authors.lastname: Liu
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005260:Female; D006322:Heart Aneurysm / Q000209:etiology / Q000601:surgery*; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D012189:Retrospective Studies; D016896:Treatment Outcome; D020257:Ventricular Remodeling