[Surgical treatment for left ventricle aneurysms. Five-year analysis]

The objective of this study was to present results of surgical repair of left ventricle aneurysms with or without myocardial revascularization and or valve replacement.

We analyzed risk factors, clinical conditions, coronary arteries affected, surgical procedure carried out, morbidity, and mortality in patients with left ventricle aneurysms treated between January 1, 1998 and December 31, 2002.

Of 1,620 patients submitted to myocardial revascularization, 24 (18 male and four females), had ventricular aneurysms. Mean age was 59.22 years. One case (4.54%) had mitral valve lesion, while remaining patients had ischemic heart disease. A total of 77.27% were in functional class III. Left anterior descending artery was most affected vessel (95.45%). Main location was anteroapical and anterolateral in 90.9%. Surgery was indicated for angina in 72.72%, while surgical repair was done for plicature in 10 cases, aneurismectomy and linear closure in six cases, and resection and geometric reconstruction in six combined with myocardial revascularization. There were no differences in times for ischemic period, cardiopulmonary bypass, and length of hospital stay. There were two deaths: one due to cardiogenic shock and the other 2 months later due to ventricular fibrillation. Follow-up time was 31.9 months and 85% of patients were in functional class I.

We concluded that the previously mentioned procedures for surgical repair of left ventricle aneurysms combined with complete myocardial revascularization offers improvement in functional class with acceptable morbidity and mortality rates.