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Left ventricular aneurysmectomy: tailored scar excision and linear closure
Maninder S Kalkat1, Uday Dandekar, Chris Smallpeice
1Department of Cardiothoracic Surgery, University Hospital of North Staffordshire, Stoke-on-Trent, ST4 7LN, United Kingdom. mankalkat@hotmail.com
Asian Cardiovascular & Thoracic Annals
|May 23, 2006
Summary
Left ventricular aneurysm repair using a modified linear closure technique demonstrated acceptable hospital mortality and long-term survival rates. This surgical approach improved patient symptoms, offering a viable treatment for left ventricular aneurysm.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Left ventricular aneurysm (LVA) is a serious complication often requiring surgical intervention.
- Debate exists regarding optimal patient selection and surgical techniques for LVA repair.
- Coronary artery bypass grafting (CABG) is frequently performed concurrently with LVA surgery.
Purpose of the Study:
- To evaluate the outcomes of left ventricular aneurysmectomy and reconstruction using a modified linear closure technique.
- To assess the safety and efficacy of this surgical approach in a cohort of patients.
Main Methods:
- Retrospective analysis of 102 consecutive patients undergoing LVA repair between 1992 and 2003.
- Utilized a modified linear closure technique for aneurysm reconstruction.
- Collected data on patient demographics, aneurysm characteristics, concomitant procedures, and clinical outcomes.
Main Results:
- Mean patient age was 62 years, with 81% males and 47% having ejection fraction < 35%.
- Common aneurysm locations included anteroapical (75%) and apical (21%).
- Hospital mortality was 7%, with a 76% long-term survival rate at 39 months follow-up. Symptomatic improvement was noted in most patients.
Conclusions:
- Left ventricular aneurysm repair with tailored scar excision and modified linear closure is a safe and effective procedure.
- The technique is associated with acceptable hospital mortality and favorable long-term survival.
- This approach offers significant symptomatic improvement for patients with left ventricular aneurysms.