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Surgical treatment of post infarction left ventricular aneurysms
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Surgical treatment for post-infarction left ventricular aneurysms (PILVA) improved heart failure symptoms in 81% of patients. Long-term survival was 68%, influenced by coronary disease severity and remaining heart muscle function.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Background:
- Post-infarction left ventricular aneurysms (PILVA) are serious complications of myocardial infarction.
- Surgical intervention is a potential treatment option for PILVA, but outcomes can vary.
Purpose of the Study:
- To analyze the results of surgical treatment for post-infarction left ventricular aneurysms.
- To identify factors influencing surgical outcomes and long-term prognosis in patients with PILVA.
Main Methods:
- Retrospective analysis of 121 patients with PILVA who underwent surgical treatment.
- Procedures included aneurysm resection alone or combined with aortocoronary bypass grafting.
- Evaluation of clinical, hemodynamic, and contractility indicators before and after surgery.
Main Results:
- Hospital mortality was 11.6%.
- 81% of patients experienced diminished or resolved heart failure symptoms post-surgery.
- 91% reported reduced or eliminated stenocardial pain.
- Five-year survival rate was 68%.
Conclusions:
- Surgical treatment outcomes for PILVA are significantly influenced by the contractile function of viable myocardium, left ventricular wall blood flow, and cardiac output.
- The ejection fraction of the contracting left ventricular portion is a key determinant of the postoperative clinical course.
- Long-term prognosis is primarily dictated by the extent of coronary artery disease and the contractile capacity of the remaining myocardium.
Abstract:
The results of surgical treatment of post-infarction left ventricular aneurysms (PILVA) in 121 patients are analyzed. 64 patients underwent resection of the aneurysm, in 57 the resection was combined with aortocoronary shunt. Hospital mortality amounted to 11.6%. Analysis of mortality in relation to the initial values of the clinical, haemodynamic and contractility indicators has shown that the results of surgical treatment depend on the contractile function of the viable part of the left ventricle, on the blood flow in the left ventricular lateral wall and on the cardiac output. After surgery, signs of heart failure diminished or disappeared in 81% of the patients. The postoperative clinical course depended on the preoperative value of the ejection fraction of the contracting part of the left ventricle. Stenocardial pain disappeared or its frequency decreased in 91% of the patients. The patients' survival rate in the five-year postoperative period was 68%. The main factors of long-term prognosis were the degree of the coronary affection and the contraction capacity of the viable myocardium.