Results of surgical management of acute left ventricular aneurysms

Over an 8-year period, 20 patients underwent operative repair of ventricular aneurysms during the first 8 weeks after acute myocardial infarction. All patients with multivessel coronary occlusive disease underwent concomitant coronary artery bypass grafting. There was one hospital death, for an early mortality rate of 5%, and one late death during follow-up, which now extends over 8 years, for a predicted actuarial 5-year survival rate of 92%. Six of the patients underwent early study and operation because of recurrent ventricular arrhythmias, with resolution of the arrthymia in all. Seventy-five percent of the survivors are not limited by symptoms and 45% are presently working working full time. These results were significantly better than those in patients who underwent operation later after infarction, although the two groups were not strictly comparable. An aggressive approach to surgical therapy in severely symptomatic patients soon after myocardial infarction can afford excellent early and long-term results.