[Effects of left ventricular reconstruction on magnetic resonance imaging derived left ventricular wall stress and...

To evaluate the effects of left ventricular reconstruction on left ventricular wall stress and function in patients with postinfarction left ventricular aneurysm.

During January 2005 to June 2006, 16 patients [15 male, (56.6 +/- 8.8) years] with postinfarction ventricular aneurysm received left ventricular reconstruction operation on CPB (5 linear repair, 6 endoventricular purse-string suture, 5 endoventricular patch repair) and CABG was also performed in 15 patients. MRI examination was made before and 3 months post operation by Siemens Magnetom Avanto 1.5T MR with routine cine-MRI in combination with late-delayed enhancement sequence. Left ventricular geometric parameters and segmental thickening were obtained with accessory image analysis software. Non-invasive blood pressure was acquired in order to compute ventricular wall stress. The revascularized and unrevascularized segments were defined by comparing the post operation revascularization of the blood-supply coronary artery with preoperative results.

A total of 192 segments including 74 unrevascularized segments were analyzed. Segmental thickening were significantly increased while wall stress were significantly reduced in both unrevascularized and revascularized segments 3 months post operation compared to preoperative values (all P < 0.05). The increase of wall thickening was positively correlated with the reduction of wall stress in these segments.

Left ventricular reconstruction plus CABG is associated with reduced left ventricular wall stress and increased myocardial contractive function in patients with postinfarction left ventricular aneurysm.