The Annals of Thoracic Surgery, Vol 38, 42-45, Copyright © 1984 by The Society of Thoracic Surgeons
Natural history of surgically treated ventricular aneurysm
JR Skinner, C Rasak, C Kongtahworn, SJ Phillips, RH Zeff, RS Toon and VB Solomon
Forty-one patients underwent resection of a postinfarction ventricular
aneurysm. Thirty-seven of them had associated saphenous vein grafting
procedures (average, 2.3 grafts per patient). Thirty-five patients
sustained left ventricular dysfunction preoperatively. Forty patients were
followed until death or for a minimum of five years (1 was lost to
follow-up), and functional status was evaluated. Hospital mortality was
12%. Twenty-four patients survived five years or longer, and 20 patients
were alive after a mean follow-up of 84 months. Eighty percent of the
nonsurvivors died of atherosclerosis-related events. Forty-nine percent of
the patients who survived the operation sustained severe atherosclerotic
events postoperatively. Only 2 of 15 nonsurvivors ever regained functional
status as judged by return to work. Twelve of the 20 long-term survivors
returned to work. Of those patients less than 50 years old at operation,
only 17% returned to work. Preoperative left ventricular function was a
significant predictor of long-term functional results of aneurysmectomy and
saphenous vein grafting. All patients remained at high risk for continued
events related to atherosclerotic cardiovascular disease, and only 37%
returned to full- time, preoperative work status. Return to productive
status was especially disappointing in patients less than 50 years old.
