[Surgical treatment of left ventricular aneurysm associated with mitral regurgitation]

The purpose of this study is to analyze the early and late results of left ventricular aneurysmectomy in patients with mitral regurgitation secondary to myocardial infarction. Twenty patients who had left ventricular aneurysm combined with mitral regurgitation underwent the isolated or combined aneurysmectomy during the last 10 years. There were 18 male cases and 2 female cases, and their age ranged from 31 to 64 (mean age 52.6 years). In 19 cases, the left ventricular aneurysm were caused secondary to antero-septal infarction due to the occlusion of the left anterior descending coronary artery. In one case, the coronary spasm of circumflex artery provoked the posterolateral myocardial infarction and the tendon rupture of posterior papillary muscle. The isolated left ventricular aneurysmectomy were performed in 6 cases and the combined operations were coronary artery bypass grafting in 11 cases, mitral annuloplasty in 1 case, mitral annuloplasty and bypass grafting in 1 case, and mitral replacement in 1 case. There were no operative death cases. The preoperative mean functional class (NYHA classification) was 2.9 and the postoperative class was 1.4. The preoperative mitral regurgitation of grade 1 in Sellers' classification was observed in 11 cases. Grade 2 regurgitation was observed in 6 cases, grade 3 in 2 and grade 4 in 1. After surgery, mitral regurgitation more than grade 2 was recognized in 3 cases (group A) and regurgitation less than grade 1 was seen in 17 cases (group B).(ABSTRACT TRUNCATED AT 250 WORDS)