Left ventricular aneurysm: preoperative factors and postoperative results

Among twenty-three patients who underwent surgery for left ventricular aneurysm, the operative mortality, hospital death and late mortality were 0, 1 (4%) and 1 (4%), respectively. Preoperative hemodynamic and radiographic factors were compared between those cases treated with intraaortic balloon pumping (IABP) because of postoperative low cardiac output syndrome (LCOS) and those cases without IABP. Employment of concomitant coronary revascularization and the factors related to myocardial protection showed no significant difference between the two groups. Moreover, there were no differences in preoperative hemodynamic parameters such as cardiac index, stroke volume index and overall left ventricular ejection fraction (EF). However, the EF of the contractile segment (CSEF) and functional parameters calculated by geometric method were well preserved in the non-IABP group. From these data, we concluded that patients who showed a CSEF of less than 45%, a left ventricular aneurysm volume index of more than 55 ml/M2 and a percent change of short axis diameter in contractile segment of less than 20 percent were more susceptible to LCOS after resection of left ventricular aneurysm.