The Annals of Thoracic Surgery, Vol 26, 357-363, Copyright © 1978 by The Society of Thoracic Surgeons
Determinants of long-term survival after ventricular aneurysmectomy
DM Cosgrove, FD Loop, MJ Irarrazaval, LK Groves, PC Taylor and LA Golding
To determine the effect of aneurysmectomy solely or combined with direct
revascularization, 349 consecutive surgical patients treated between 1962
and 1972 were retrospectively reviewed. The minimum follow- up for
survivors was 5 years (mean, 7 years). Single-vessel disease occurred in
171 (49%) and only ventricular aneurysmectomy was performed (Group 1).
Multiple-vessel disease was found in 178 (51%), of whom 79 (44%) had
resection of a ventricular aneurysm and revascularization of all major
obstructed vessels (Group 2); 99 (56%) had aneurysm resection and
incomplete revascularization (Group 3). Survival at 7 years was 69% for
Group 1, 65% for Group 2, and 51% for Group 3. Actuarial survival at 7
years was 70% for patients operated on for angina; 55% for congestive heart
failure; 57% for a combination of angina and heart failure; and 64% for
ventricular tachycardia. Survival of patients with multiple-vessel disease
who underwent aneurysmectomy and complete revascularization was similar to
that of patients with single-vessel disease who underwent aneurysmectomy
alone. Longevity is adversely influenced by incomplete revascularization (p
less than 0.005) and preoperative congestive heart failure (p less than
0.005).
