The Annals of Thoracic Surgery, Vol 21, 107-113, Copyright © 1976 by The Society of Thoracic Surgeons
Surgical treatment of postinfarction ventricular aneurysm
JM Moran, PJ Scanlon, R Nemickas and R Pifarre
We have operated on 62 consecutive patients for postinfarction ventricular
aneurysm since coronary bypass grafting became available. Analysis of
hemodynamic and angiographic data reveals that the prognosis of operation
is favorable if mean pulmonary artery pressure is less than 45 mm Hg and
cardiac index is greater than 2.0 L/min/m2; such factors as the
preoperative New York Heart Association Functional Class, number of
coronary grafts, aneurysm size, left ventricular end- diastolic pressure,
and coronary score were not closely related to the outcome of operation.
Hospital mortality was 6.5% (4 patients) and late mortality, with a mean
follow-up of two years, was 11% (7 patients). The prognosis among survivors
was good: 82% (46) achieved NYHA Class I or II status, whereas 87% (54) had
been in Class III or IV preoperatively. Concomitant vein grafting with
aneurysmectomy did not significantly enhance operative or late survival,
nor did it add appreciably to the risk of operation. Long-term benefits of
revascularization in addition to aneurysmectomy are expected but not yet
proved.
