Cor Vasa 2002, 43(11):456-460
Our experience with left ventricular aneurysm surgery at IKEM
- Klinika kardiovaskulární chirurgie, Institut klinické a experimentální medicíny, Praha, Česká republika
Aim:
To summarize and evaluate the outcome of surgery for left ventricular aneurysm.
Method:
To analyze preoperative, intra-operative, and postoperative data of patients with left ventricular aneurysm resection and reconstruction in the period from 3 May 1993 through 21 May 2001 as related to therapeutic outcome, and to compare the data with those obtained from a group of patients undergoing simple coronary artery bypass grafting (CABG) over the same period.
Results:
A total of 93 patients had surgery for left ventricular aneurysm in the above period. In-hospital and 30-day mortality was 7.5%, and was comparable with literary data. The most frequent cause of death was left-heart failure (71.4%); 50.6% of patients showed preoperative anginal symptoms of CSS (Canadian Cardiology Society) Class III or IV and 27% showed NYHA (New York Heart Association) Class III or IV dyspnoe. Acute or urgent surgery was undertaken in 24% of patients because of heart failure (9.7%), arrhythmias (9.7%) or unstable angina (3.2%). A left ventricular ejection fraction below 40% and 30% was present in 72.1% and 42% of patients, respectively. CABG was performed in 93.5% of those undergoing surgery. The left internal mammary artery was used in 75.8% of patients. There were 4 cases of re-do surgery after coronary reconstruction, and 4 patients had mitral valve replacement.
Conclusions:
The authors believe surgery in this risk group is safe and associated with a good outcome. The procedure is associated with higher perioperative mortality and morbidity rates compared to elective CABG.
Keywords: Left ventricular aneurysm; Endoventricular reconstruction
Published: November 1, 2002 Show citation