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Ann Thorac Surg 1977;23:461-466
© 1977 The Society of Thoracic Surgeons

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Articles

Left Ventricular Wall Resection for Aneurysm and Akinesia due to Coronary Artery Disease: Fifty Consecutive Patients

Divisions of Cardiothoracic Surgery and Cardiology, St Elizabeth's Hospital, and the Departments of Surgery, Tufts University School of Medicine, Harvard Medical School, and Boston University School of Medicine, Boston, MA.

Accepted for publication September 27, 1976.

^* Address reprint requests to Dr. Lefemine, St Elizabeth's Hospital, 736 Cambridge St, Brighton, MA 02135.

Left ventricular wall resection with or without vein bypass grafting was performed in 50 consecutive patients with aneurysm or an akinetic segment with poor left ventricular hemodynamics. Ejection fraction averaged 29% and left ventricular end-diastolic pressure averaged 20 mm Hg. Associated valve disease was present in 14 patients (28%). Hospital mortality was 22% (11 patients) and late mortality was 20% (10 patients). The lowest mortality (3%, 1 death) was found in patients who had anterior apical resection with associated vein bypass, in whom prophylactic balloon pumping was used when needed for ejection fractions of less than 30%. A high mortality occurred with associated valve replacement (6 deaths, 86%) and posterior aneurysm. Among 39 patients followed for an average of twenty-four-months, 34 (87%) improved one class and 18 (46%) improved two classes of the New York Heart Association Functional Classification.

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