Surgery for chronic left ventricular aneurysm. Benefits and side effects

Area of Science:

• Cardiology
• Cardiac Surgery
• Cardiovascular Imaging

Background:

• Postinfarction left ventricular (LV) aneurysms are a significant complication, often leading to heart failure and reduced quality of life.
• Surgical intervention, including aneurysm resection and coronary revascularization, is considered for symptomatic patients.

Purpose of the Study:

• To review outcomes of elective resection for symptomatic postinfarction LV aneurysms.
• To assess early mortality, mural thrombosis, and ventricular function recovery after surgery.

Main Methods:

• Retrospective review of 70 patients undergoing LV aneurysm resection with or without coronary revascularization.
• Analysis of preoperative and postoperative left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), and stress test variables.

Main Results:

• Early mortality was 5.7%; mural thrombosis occurred in 41.4% of cases.
• Significant improvement in global LVEF and stress test variables was observed postoperatively.
• A slight but significant decrease in RVEF was noted, particularly in patients with angina as the dominant symptom.

Conclusions:

• Surgical resection of LV aneurysms generally improves LV function, especially in patients with poor preoperative function.
• Potential right ventricular deterioration is a consideration, and careful patient selection is crucial.
• For patients with well-preserved LVEF and small aneurysms, revascularization alone may be a preferred strategy.