[Behavior of left ventricular filling after left ventricular aneurysmectomy: evaluation by pulsed Doppler...

The pattern of diastolic flow velocity was studied using pulsed Doppler echocardiography to evaluate postoperative left ventricular (LV) diastolic function in patients who underwent left ventricular aneurysmectomy. This study involved 16 patients who experienced ischemic heart disease from January 1985 to April 1986. The patients were categorized in two groups; the aneurysm group comprised by seven patients undergoing aneurysmectomy, and the bypass group which included nine patients undergoing only coronary artery bypass grafting. Pulsed Doppler studies were performed five to 22 days before, and at an average of 12 days after surgery. Preoperative cardiac catheterization and cineangiography were performed and, myocardial infarct size was estimated by the Wagner's method. Using pulsed Doppler echocardiography, LV filling dynamics were assessed by the peak velocity in the rapid filling phase (R), the peak velocity in the atrial contraction phase (A), and the ratio of A to R (A/R ratio) of the mitral flow velocity pattern. All data were average in five consecutive beats. 1. The estimated myocardial infarct size (%MI) in both groups before surgery was 38.5% in the aneurysm group and 32.5% in the bypass group, and there was no significant difference between these groups. 2. The preoperative cardiac index (2.9 in the aneurysm group vs 2.8 1/min/m2 in the bypass group), left ventricular end-diastolic pressure (16.1 vs 17.3 mmHg), and left ventricular ejection fraction (0.43 vs 0.36) were not significantly different between the two groups. 3. The preoperative A/R ratio was 1.5 in the aneurysm group and this was significantly higher than that of the bypass group (1.2).(ABSTRACT TRUNCATED AT 250 WORDS)