Surgical treatment of the post-infarction left ventricular aneurysm. Factors influencing early and late results

The Thoracic and Cardiovascular Surgeon
J M Gonzalez-SantosL C Pelletier

Abstract

The early and late results of a 4 year surgical experience with 119 left ventricular aneurysms (LVA) are analyzed. The most common indication for surgery was angina in 78 patients, congestive heart failure (CHF) in 34, arrhythmia in 5 and recurrent embolism in 1. One patient was operated on prophylactically. There were 112 "anterior" and 7 "posterior" aneurysms. Preoperative ventricular function was significantly worse in the CHF group. LVA resection was carried out in 105 patients and a plicature in other 14. In 92 cases the procedure was combined with a myocardial revascularization. Additional cardiac procedures were performed in 14 patients. Overall early (5.9%) and late mortality (18.7%) was significantly higher in the CHF group than in the angina group (14.7% versus 1.3%, p less than 0.01, and 37.9% versus 12.9%, p less than 0.01, respectively). Associated surgical procedures (p less than 0.001) and acuity of the LVA (p less than 0.05) also increased the operative risk. The 5 year-survival was better for the angina group (85.7 +/- 4%) and arrhythmias group (80 +/- 22%) than for CHF patients (46.7 +/- 19%) (p = 0.052). Functional improvement was uniform between survivors of all groups (73.2%). In 15 patients with pre- and p...Continue Reading

Citations

Jan 1, 1989·Scandinavian Journal of Thoracic and Cardiovascular Surgery·J L SvennevigE Sivertssen
Jul 15, 1991·The American Journal of Cardiology·P A BaciewiczR A Guyton

Related Concepts

Low Cardiac Output Syndrome
Heart Aneurysm
Cardiac Surgery Procedures
Myocardial Infarction
Postoperative Period
Preoperative Procedure
Stroke Volume

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