Long-term Results after Reconstructive Surgery for Aneurysms of the Left Ventricle

Authors

  • Daniel Uni?
  • Davor Bari?
  • Željko Sutli?
  • Igor Rudež
  • Mira Ivkovi?
  • Mislav Planinc
  • Dubravka Jonji?

DOI:

https://doi.org/10.1532/HSF98.20091126

Abstract

Background: Aneurysms of the left ventricle (LV) present a serious consequence of myocardial infarction, causing mechanical, thromboembolic, and arythmogenic complications. We present our experience in LV remodeling and long-term follow-up results.

Methods: From May 1998 to February 2009, 85 patients with postinfarction LV aneurysm underwent reconstructive procedures. Mean age was 58.7 ± 8.9 years (range 36-79 years). Average LV ejection fraction was 39.8% ± 13.1% (range 20%-70%). Mean EuroScore was 6.0 ± 2.9 (range 3-19) and predictive mortality was 8.2% ± 11.9% (range 1.6%-85.6%). The majority of patients were in New York Heart Association functional class II (44%) preoperatively and 32% of patients were in New York Heart Association class III or IV. LV reconstruction was performed by using the endoventricular patch technique in 56 patients (66%). In 29 patients (34%) reconstruction was done by linear closure. In 79 patients (93%) concomitant myocardial revascularization was performed. Mitral valve procedures were performed in 11 patients (13%), (repair in 10 patients and replacement in 1).

Results: Perioperative mortality was 3.5% (3 patients). Long-term follow-up was completed by means of phone interview with an average duration of 31.6 months (range 3-120 months). There were 9 late deaths (11%) during follow-up. Actuarial survival rates at 1, 5, and 10 years were 91%, 77%, and 68%, respectively. Fifty-nine patients (72%) were in New York Heart Association functional class I and II postoperatively.

Conclusion: LV remodeling is a safe surgical procedure with low perioperative morbidity and mortality and excellent long-term survival, even in patients with severely reduced systolic function.

References

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Published

2009-12-24

How to Cite

Uni?, D., Bari?, D., Sutli?, Željko, Rudež, I., Ivkovi?, M., Planinc, M., & Jonji?, D. (2009). Long-term Results after Reconstructive Surgery for Aneurysms of the Left Ventricle. The Heart Surgery Forum, 12(6), E354-E356. https://doi.org/10.1532/HSF98.20091126

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