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Ann Thorac Surg 1989;47:746-751
© 1989 The Society of Thoracic Surgeons
Medical Department B, Rikshospitalet, University of Oslo, Oslo, Norway
Accepted for publication November 30, 1988.
* Address reprint requests to Dr Mangschau, Medical Department, Ski Hospital, Box 295, 1401 Ski, Norway.
Forty-one patients selected for left ventricular aneurysm resection and coronary artery bypass grafting were studied by gated radionuclide ventriculography and right heart catheterization before and after operation to establish whether the presence of paradoxically systolic expansion, as defined by radionuclide ventriculography, influenced the surgical outcome. Patients with systolic paradoxically moving left ventricular aneurysms (n = 28) improved their functional classification (New York Heart Association) (p < 0.01) and exercise tolerance (watt-minutes) (p < 0.001) compared with preoperative values, in contrast to the patients with akinetic aneurysms (n = 13), whose status remained unchanged. Left ventricular ejection fraction at rest (p < 0.001) and exercise (p < 0.0001) improved along with a significant reduction in left ventricular end-diastolic (p < 0.002) and end-systolic volume indices (p < 0.001) among the patients with paradoxical left ventricular aneurysms versus no change in the akinetic group. In a multivariate analysis of different preoperative variables, the presence of dyskinesia was found to be the only independent predictor of a favorable surgical outcome (p < 0.004). In conclusion, the presence of dyskinesia represents an important marker of the outcome after aneurysmectomy.
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