The Annals of Thoracic Surgery, Vol 25, 336-339, Copyright © 1978 by The Society of Thoracic Surgeons
Left ventricular aneurysm resection: indications and long-term follow- up
RC Shaw, TB Ferguson, CS Weldon and JP Connors
Forty-four patients had resection of a chronic postinfarction left
ventricular aneurysm. Operative indications were heart failure, angina, and
ventricular arrhythmias. Twenty-six patients (59%) had coronary grafting in
addition to aneurysmectomy. The operative mortality rate was 4.5% (2/44),
and late mortality (mean follow-up, 31 months) was 17.9% (7/39).
Preoperatively all patients were in New York Heart Association Functional
Class III or IV; 91% were Class I or II postoperatively. Coronary bypass
grafting did not increase the operative mortality rate, and long-term
survival was similar between those receiving coronary grafts and those not
receiving grafts. Postoperative ventriculograms were evaluated in 10
patients by means of a system of internal grids. Amount of regional
myocardial contraction correlated well with the patient's postoperative
functional capacity. It is concluded that ventricular aneurysmectomy in
combination with coronary bypass grafting is safe and effective, resulting
in marked improvement in the patients' functional capacity and longevity.