Resection of postinfarction left ventricular aneurysm with and without revascularization

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes

Background:

• Ventricular aneurysms often present with significantly impaired cardiac function.
• Surgical intervention is considered for patients with large ventricular aneurysms and reduced ejection fraction.

Purpose of the Study:

• To evaluate the outcomes of surgical resection for ventricular aneurysms.
• To compare the efficacy of ventricular aneurysm resection with and without myocardial revascularization.
• To assess the safety and survival benefits of these procedures in patients with compromised left ventricular function.

Main Methods:

• Retrospective analysis of 53 patients undergoing ventricular aneurysm resection.
• 24 patients had aneurysm resection alone, while 29 underwent resection plus myocardial revascularization.
• Intraoperative and postoperative data, including mortality and long-term survival, were collected.

Main Results:

• Overall in-hospital mortality was 5.7% (3 out of 53 patients).
• Survival at four years was 75.5% for all patients.
• Patients with ejection fraction ≤ 0.4, including those with ejection fraction ≤ 0.2, showed improved survival compared to historical medical treatment (12% at five years).

Conclusions:

• Surgical resection of ventricular aneurysms, particularly when combined with myocardial revascularization, is associated with low operative risk.
• These surgical approaches offer a substantial survival benefit for patients with ventricular aneurysms and impaired left ventricular function compared to medical management.