[Surgical treatment of left ventricular aneurysm (author's transl)]

174 cardiac aneurysms were resected between 1970 and 1977. In 49 patients the remaining contractile segment was revascularised at the same time. The hospital mortality was 10.3%, the late mortality was 14%. The uncorrected cumulative survival rate calculated by the acturial method was 90% at 3 years (84--96), and 80% at 5 years (74--85). Results were excellent or good in two thirds of the survivors; 44% were free of angina pectoris, 40% were improved, 73% had no disturbances of cardiac rhythm, and in 15% they were improved. Comparison of the pre- and postoperative ejection fraction showed that the indication for surgery of a cardiac aneurysm exists when more than 20% of the musculature of the left ventricle is affected, when the total ejection fraction is larger than 10% when one vessel is affected, and more than 30% when more than one vessel is affected. Contraindications are diffuse coronary heart disease, when ejection fraction of the contractile segment is less than 30% reduction in contractility of the ventricular septum, and the generally applicable surgical contraindications.