Left ventricular aneurysmectomy. Factors influencing postoperative results

Area of Science:

• Cardiology
• Cardiac Surgery
• Cardiovascular Research

Background:

• Left ventricular aneurysms (LVAs) are serious complications often associated with coronary artery disease.
• Surgical intervention for LVAs aims to improve symptoms and survival but carries risks.
• Patient outcomes following LVA resection are influenced by various clinical factors.

Purpose of the Study:

• To analyze the outcomes of left ventricular aneurysm resection in a consecutive patient cohort.
• To identify predictors of early and late mortality after left ventricular aneurysmectomy.
• To evaluate the impact of primary indications for surgery on patient prognosis.

Main Methods:

• Retrospective review of 100 consecutive patients undergoing left ventricular aneurysm resection.
• Analysis of patient data including primary indication for surgery, ventricular function, and coronary artery anatomy.
• Stratification of patients based on preoperative symptoms (angina, arrhythmias, heart failure) and cardiac status.

Main Results:

• Early mortality varied significantly by indication: 4% for angina, 56% for arrhythmias, and 21% for heart failure.
• Late mortality also differed: 4% for angina, 0% for arrhythmias, and 34% for heart failure.
• Optimal outcomes in heart failure patients were observed with good preoperative ventricular function and favorable coronary anatomy; poorest outcomes were in those with complex coronary disease.

Conclusions:

• Left ventricular aneurysm patients represent a heterogeneous group with markedly variable prognoses.
• Careful preoperative evaluation of symptoms, ventricular function, and coronary artery anatomy is essential for predicting surgical success.
• Risk stratification based on preoperative assessment can guide surgical decision-making and patient counseling.