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Left ventricular aneurysm repair: a comparison of linear versus patch remodeling
Wei-Yuan Chen1, Fei-Yi Wu, Chun-Che Shih
1Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
Journal of the Chinese Medical Association : JCMA
|August 19, 2009
Summary
Surgical repair of left ventricular (LV) aneurysms using linear or patch remodeling shows similar outcomes, except for right ventricular function. Individualized patient selection is recommended for optimal results.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Surgical repair of left ventricular (LV) aneurysms has a 50-year history.
- Optimal surgical approach for LV aneurysm repair remains debated.
- This study compares linear versus patch remodeling for dyskinetic LV aneurysms.
Purpose of the Study:
- To compare the efficacy of linear and patch remodeling techniques for surgical repair of dyskinetic left ventricular aneurysms.
- To assess short-term and mid-term outcomes, including complications, cardiac function, and mortality.
Main Methods:
- Retrospective review of 49 patients undergoing LV aneurysm repair (1996-2006).
- 31 patients had patch remodeling, 18 had linear repair.
- Outcomes assessed included inhospital mortality, complications, cardiac function, and long-term survival.
Main Results:
- No significant differences in inhospital mortality, major complications, or early hemodynamics between groups.
- Mid-term follow-up showed similar improvements in LV ejection fraction for both techniques.
- Patch remodeling maintained right ventricular ejection fraction, while linear repair showed deterioration.
Conclusions:
- Both linear and patch repair techniques demonstrate comparable short- and mid-term effectiveness for LV aneurysms.
- Right ventricular ejection fraction is a key differentiator, favoring patch remodeling.
- Individualized patient selection based on aneurysm characteristics is crucial for optimal surgical outcomes.
