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Surgical treatment in postinfarction left ventricular pseudoaneurysm
I Golbasi1, E Atahan, C Turkay
1Department of Cardiovascular Surgery, Akdeniz University School of Medicine, Antalya, Turkey. golbasi@akdeniz.edu.tr
Minerva Chirurgica
|May 24, 2007
Summary
Surgical repair of left ventricular pseudoaneurysms following myocardial infarction offers a viable treatment option. While early mortality exists, long-term outcomes show symptom resolution or manageable heart failure in survivors.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Left ventricular pseudoaneurysms (LVPs) are rare but serious complications following myocardial infarction.
- Surgical intervention is often necessary for LVPs to prevent rupture and manage hemodynamic instability.
Purpose of the Study:
- To evaluate the outcomes of surgical treatment for patients diagnosed with left ventricular pseudoaneurysms.
- To analyze the efficacy and safety of surgical repair in this patient cohort.
Main Methods:
- A retrospective review of 7 patients who underwent surgical repair of LVPs between June 1990 and March 2007.
- LVPs were resected, and defects were closed using Teflon patches or direct sutures.
- Coronary artery bypass grafting was performed in 5 patients concurrently.
Main Results:
- The median time from myocardial infarction to LVP diagnosis was 2.6 months.
- Teflon patches were used for defect closure in 6 patients; direct sutures reinforced with Teflon felt were used in 1 patient.
- Mean follow-up was 45 months, with no intraoperative deaths but 2 early deaths due to multiple organ failure.
Conclusions:
- Surgical management of LVPs can be performed with no intraoperative mortality.
- Early postoperative mortality occurred in 2 patients due to multiple organ failure.
- Late survival varied, with some patients remaining asymptomatic and others experiencing heart failure or mitral regurgitation.
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