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Surgical experience with postinfarction ventricular aneurysm.

T L Fudge, J L Ochsner, N L Mills

    Southern Medical Journal
    |January 1, 1977
    PubMed
    Summary
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    Surgical treatment for postinfarction ventricular aneurysms, including resection and plication, showed promising long-term survival. Aneurysmectomy is recommended for significant ventricular aneurysms, with outcomes influenced by coronary artery disease severity.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Cardiovascular Research

    Background:

    • Postinfarction ventricular aneurysms pose significant risks, including heart failure, arrhythmias, and thromboembolic events.
    • Surgical intervention is considered for patients with symptomatic or hemodynamically significant aneurysms.

    Purpose of the Study:

    • To evaluate the outcomes of surgical treatment for postinfarction ventricular aneurysms.
    • To identify factors influencing mortality and long-term survival after aneurysmectomy.

    Main Methods:

    • Retrospective analysis of 58 patients undergoing surgical treatment (resection or plication) for postinfarction ventricular aneurysms.
    • Procedures included aneurysmectomy, often combined with myocardial revascularization.
    • Diagnostic tools included cineventriculography and coronary cineangiography.

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    Main Results:

    • Overall hospital mortality was 14%, directly proportional to coronary artery disease severity (0% for single-vessel, 10% for double-vessel, 24% for triple-vessel).
    • Left ventricular end-diastolic pressures did not significantly affect mortality.
    • Long-term survival was observed in 46 out of 58 patients (79%) from six months to eight years postoperatively.

    Conclusions:

    • Aneurysmectomy is the preferred surgical approach for ventricular aneurysms with hemodynamic significance, clots, arrhythmias, or embolic phenomena.
    • Elevated left ventricular end-diastolic pressure (>25 mm Hg) is not a contraindication for surgery.
    • Triple-vessel coronary artery disease increases surgical risk but does not preclude favorable outcomes.