[Surgical treatment of ventricular aneurysm: an analysis of post-resection haemodynamic changes (author's transl)]

Of 500 patients with angiographically proven myocardial infarction 75 had a left ventricular aneurysm. 25 of them subsequently had resection of the aneurysm. Postoperative studies revealed marked improvement of symptoms. Pulmonary arterial pressure was significantly decreased at rest (from 28 to 20 mm Hg) and on exercise (from 58 to 35 mm Hg). There was a reduction in left ventricular end-diastolic volume (from 247 to 1.54 ml/1.73 m2) and a raised ejection fraction (from 36 to 59%). Good results were obtained especially in those patients who had congestive heart failure due to paradoxical systolic expansion of the ventricular wall and (or) secondary reversible damage in the remaining viable myocardium. Left ventricular aneurysms should be suspected after myocardial infarction when there is left ventricular failure and an increase in heart size.