Left Ventricular Aneurysm Repair with Myocardial Revascularization: An Analysis of 246 Consecutive Patients over 15 Years

• Published in: The Annals of thoracic surgery Vol. 46; no. 1; pp. 29 - 35
• Main Authors: Vauthey, Jean-Nicolas, Berry, Don W., Snyder, David W., Gilmore, James C., Sundgaard-Riise, Kirsten, Mills, Noel L., Ochsner, John L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.07.1988; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Arrhythmias, Cardiac - mortality; Arrhythmias, Cardiac - therapy; Biological and medical sciences; Cardiology. Vascular system; Coronary Disease - complications; Coronary Disease - mortality; Coronary Disease - surgery; Coronary heart disease; Female; Heart; Heart Aneurysm - complications; Heart Aneurysm - mortality; Heart Aneurysm - surgery; Heart Ventricles; Humans; Male; Medical sciences; Middle Aged; Myocardial Revascularization - mortality; Postoperative Complications - mortality; Postoperative Complications - therapy; Time Factors; Human; Resection; Aortocoronary; Bypass; Surgery; Aneurysm; Cardiovascular disease; Coronary heart disease; Left ventricle
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(10)65847-X

From 1970 to 1985, 246 consecutive patients with left ventricular (LV) aneurysm underwent repair and concomitant myocardial revascularization at Ochsner Foundation Hospital. The overall incidence of perioperative death was 7.3%. Although the deaths were mainly cardiac related (10/18) with congestive heart failure (CHF) as the leading cause (6/10), 8 deaths were of noncardiac origin. Perioperative mortality increased significantly in patients with mitral regurgitation (MR) (22%; p = 0.0008); perioperative mortality for patients without MR was 4.8%. The overall 5-year survival was 69%. Late deaths were caused most commonly by myocardial infarction (20/32) with only 7 due to CHF. Predictors of long-term survival were related to LV function preoperatively: absence of CHF ( p = 0.001); LV end-diastolic pressure less than or equal to 20 mm Hg ( p = 0.03); and ejection fraction greater than or equal to 35% ( p = 0.02). Factors that did not significantly affect long-term survival were type of aneurysm repair (resection or plication), morphology of left anterior descending coronary artery (occlusion or stenosis), and size of the aneurysm.