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Combined left ventricular aneurysm and coronary artery bypass surgery: long-term results of 100 consecutive patients
Insights
Left ventricular aneurysm resection is a complex procedure for coronary atherosclerosis complications. Surgical judgment is key, with favorable outcomes for patients undergoing concomitant coronary artery bypass grafting.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Background:
- Coronary atherosclerosis frequently leads to left ventricular wall motion abnormalities.
- Left ventricular aneurysms are a serious complication requiring surgical intervention.
Purpose of the Study:
- To evaluate the outcomes of left ventricular aneurysm resection in patients with coronary atherosclerosis.
- To identify factors influencing the success of this surgical procedure.
Main Methods:
- Retrospective analysis of 100 patients undergoing left ventricular aneurysm resection or plication between 1971 and 1977.
- Assessment of operative mortality, long-term survival, and functional recovery.
Main Results:
- Operative mortality was 7%, with a 6-year actuarial survival of 78%.
- 88% of survivors achieved excellent or good functional status (New York Heart Association classes I and II).
- Age, congestive heart failure, and poor left ventricular function adversely affected outcomes.
Conclusions:
- Concomitant coronary artery bypass grafting appeared to improve outcomes and functional recovery.
- Careful patient selection and surgical judgment are critical for successful left ventricular aneurysm resection.
Abstract:
Forty-four percent of 2,367 patients who had operations for the complications of coronary atherosclerosis between 1971 and 1977 were noted to have major left ventricular wall motion abnormalities. Of this group, 100 patients required left ventricular aneurysm resections or plications (4.2%). There were 85 men and 15 women. Their average age was 52 years (range, 30 to 68 years). Concomitant coronary artery bypass grafting was required in 95 patients. The operative mortality was 7% and the actuarial survival at six years was 78%. Patients were followed for an average of 31 months (range, 3 to 72 months). Eighty-eight percent of the survivors had excellent or good results with improvement of their functional status to the New York Heart Association classes I and II. Age, congestive heart failure, and poor residual left ventricular function had an adverse effect on the outcome of these patients. Concomitant coronary artery bypass grafting seems to have favorably influenced their outcome and functional recovery. Surgical judgment is of great importance in selecting which patients require left ventricular aneurysm resection.