Long-term results after reconstructive surgery for aneurysms of the left ventricle

• Published in: The Heart surgery forum Vol. 12; no. 6; p. E354
• Main Authors: Unić, Daniel, Barić, Davor, Sutlić, Zeljko, Rudez, Igor, Ivković, Mira, Planinc, Mislav, Jonjić, Dubravka
• Format: Journal Article
• Language: English
• Published: United States 01-12-2009
• Subjects: Adult; Aged; Comorbidity; Croatia - epidemiology; Female; Heart Aneurysm - mortality; Heart Aneurysm - surgery; Heart Ventricles - surgery; Humans; Longitudinal Studies; Male; Middle Aged; Prevalence; Reconstructive Surgical Procedures - mortality; Survival Analysis; Survival Rate; Treatment Outcome; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - surgery; Croatia
• ISSN: 1522-6662
• DOI: 10.1532/HSF98.20091126

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.
From May 1998 to February 2009, 85 patients with postinfarction LV aneurysm underwent reconstructive procedures. Mean age was 58.7 + or - 8.9 years (range 36-79 years). Average LV ejection fraction was 39.8% + or - 13.1% (range 20%-70%). Mean EuroScore was 6.0 + or - 2.9 (range 3-19) and predictive mortality was 8.2% + or - 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).
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.
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.