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Ann Thorac Surg 1978;26:357-363
© 1978 The Society of Thoracic Surgeons

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Articles

Determinants of Long-Term Survival after Ventricular Aneurysmectomy

Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation and The Cleveland Clinic Educational Foundation, Cleveland, OH.

^* Address reprint requests to Dr. Cosgrove, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106.

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 < 0.005) and preoperative congestive heart failure (p <0.005).

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