The Annals of Thoracic Surgery, Vol 23, 455-460, Copyright © 1977 by The Society of Thoracic Surgeons
Prognostic considerations in the management of left ventricular aneurysms
DC Mullen, L Posey, R Gabriel, HM Singh, RJ Flemma and D Lepley Jr
This report summarizes a four-year experience with 60 patients who had left
ventricular aneurysm (LVA) resection and bypass of all significantly
diseased coronary arteries, with an operative and late mortality of 3.3 and
8.3%, respectively. Their cardiac catheterizations were reviewed, and the
only values that seemed to reflect prognosis were preoperative cardiac
index and the presence of absence of septal motion. The lower the cardiac
index, the less likely the patient was to do well postoperatively. There
were now survivors who had lacked septal motion by left anterior oblique
ventriculogram. Patients without septal motion are therefore no longer
considered surgical candidates. If septal motion is present, resection of
LVA carries no more risk than myocardial revascularization without LVA.