[Surgical correction of the ventricular geometry in post-infarction left ventricular aneurysms]

Left ventricular aneurysm (LVA) following myocardial infarction carry a high morbidity and mortality, which may be reduced by appropriate surgical treatment. The Jatene correction is an attractive technique for aneurysm repair. We have employed a modified Jatene correction in 72 patients between July 1986 and May 1995. There were 57 men and 15 women, mean age 61.6 +/- 8.2 years old. Fifteen patients (21%) presented with malignant recurrent ventricular arrhythmias. Fourteen patients had emergency operations and 3 were redo coronary artery bypass grafts. Fifty-eight patients (83%) were in NYHA class III and IV. Fifty-two patients had 3-vessel disease. Preoperative left ventricular ejection fraction (LVEF) was 30.4 +/- 12.2% (10-59%) and left ventricular end-diastolic pressure was 26.2 +/- 10.1 mmHg (12-41 mmHg). The overall perioperative mortality was 11.1%, one patient had a peroperative myocardial infarction. Immediately postoperatively, 17 patients had low cardiac output, requiring intraaortic balloon pump in eight cases. There were no bleeding problems and 30 patients (42%) had no postoperative complications whatsoever. The average hospital stay was 10.2 days. Left ventricular cavity size, measured (echocardiography) showed significant reduction 1 week postoperatively, which was unchanged after 1 month. The left ventricular ejection fraction was significantly increased 1 month postoperatively. After follow-up, on average 20 months, there was significant improvement in mean NYHA class. The modified Jatene correction of left ventricular aneurysm is simple, carries acceptable mortality and low morbidity and significantly improves left ventricular function.