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MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection
Michel I M Versteegh1, Hildo J Lamb, Jeroen J Bax
1Department of Cardio-thoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. m.i.m.versteegh@lumc.nl
Objectives:
Whether resection of a left ventricular (LV) aneurysm leads to improved global LV function remains controversial. Echo-planar magnetic resonance imaging (MRI) is a sensitive tool to detect changes in LV function. Therefore, the purpose of the present study was to monitor changes in global LV function and anatomy following LV aneurysm resection using MRI.
Methods:
The present study includes 12 patients with an anterior LV aneurysm. Echo-planar MRI evaluation of LV function was performed before surgery and 6 weeks and 3 months after LV remodeling surgery, in most patients combined with coronary artery by-pass grafting (CABG).
Results:
Following LV aneurysm resection, a decrease was found in end-diastolic volume from 238+/-63 to 180+/-54 ml at 6 weeks to 198+/-51 ml (P<0.05) at 3 months and in end-systolic volume from 156+/-62 to 105+/-44 to 111+/-43 ml (P<0.01), whereas the ejection fraction increased from 37+/-11 to 43+/-9 to 45+/-10% (P<0.01).
Conclusions:
LV remodeling surgery leads to a cardiac anatomy more closely resembling normal anatomy. As a consequence, LV contractile function improved significantly. In addition, it was shown that echo-planar cardiac MRI is a sensitive tool to study subtle changes in heart anatomy and function. In this preliminary experience, pre- and postoperative MRI has demonstrated that LV remodeling surgery may restore cardiac anatomy and improve LV contractile function.