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Ventricular aneurysm resection. Trends in surgical risk
D M Cosgrove1, B W Lytle, P C Taylor
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195-5066.
Circulation
|June 1, 1989
Summary
Ventricular aneurysm resection incidence decreased from 1972-1987. Despite older patients and complex surgeries, operative risk remained constant, with cardiac causes leading to increased mortality.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
Background:
- Ventricular aneurysm resection was a significant surgical procedure.
- Patient demographics and management strategies have evolved over time.
Purpose of the Study:
- To analyze trends in ventricular aneurysm resection from 1972 to 1987.
- To evaluate changes in patient characteristics, surgical approaches, and outcomes.
Main Methods:
- Retrospective analysis of 1,183 patients undergoing ventricular aneurysm resection.
- Data stratified into four 4-year intervals for comparative analysis.
- Multivariate analysis to identify risk factors for mortality.
Main Results:
- Significant increase in mean patient age (59.4 years) and prevalence of congestive heart failure (43.4%).
- Increased use of mammary and associated grafts, with 47.2% complete revascularization in the most recent interval.
- Overall mortality rate increased to 8%, with cardiac causes predominating; emergent procedures, age, left main trunk disease, and heart failure were risk factors.
Conclusions:
- The incidence of ventricular aneurysm resection has declined.
- Operative risk has remained consistent despite an aging patient population and more complex procedures.
- Cardiac complications remain a primary cause of mortality post-resection.