Left Ventricular Aneurysm Repair: Off-pump Linear Plication versus On-pump Patch Plasty

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Minimally Invasive Cardiac Procedures

Background:

• Left ventricular aneurysm (LVA) repair is crucial for managing heart failure and preventing rupture.
• Traditional patch plasty carries risks, prompting research into alternative surgical techniques.

Purpose of the Study:

• To compare the clinical outcomes of simplified linear plication versus classic patch plasty in LVA repair.
• To evaluate early surgical results and long-term survival rates between the two techniques.

Main Methods:

• Retrospective review of 282 patients undergoing LVA repair (2006-2016).
• Propensity score matching created 45 pairs for comparison: on-pump patch plasty vs. off-pump linear plication.
• Comparison of early outcomes (e.g., low cardiac output syndrome, recovery time) and long-term survival.

Main Results:

• Similar heart function improvement at discharge for both groups.
• The patch group experienced more low cardiac output syndrome and required more intra-aortic balloon pumping assistance.
• The plication group demonstrated significantly shorter recovery times (mechanical ventilation, ICU, and hospital stay).
• No significant difference in long-term survival was observed between the groups.

Conclusions:

• Off-pump linear plication offers acceptable early and long-term outcomes for LVA repair.
• Simplified LVA repair techniques, like linear plication, represent a promising option for high-risk surgical candidates.