Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography

• Published in: The American journal of cardiology Vol. 56; no. 13; pp. 857 - 860
• Main Authors: Visser, Cees A., Kan, Gerard, Meltzer, Richard S., Moulijn, Ad C., David, George K., Dunning, Arend J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-11-1985; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Echocardiography - methods; Female; Heart; Heart Aneurysm - diagnosis; Heart Aneurysm - etiology; Heart Aneurysm - surgery; Humans; Male; Medical sciences; Middle Aged; Mitral Valve - surgery; Myocardial Infarction - complications; Postoperative Complications - mortality; Prognosis; Time Factors; Human; Echocardiography; Resection; Surgery; Ultrasonic investigation; Aneurysm; Cardiovascular disease; Coronary heart disease; Left ventricle; Two dimensional technique
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(85)90769-6

Mortality of surgical resection of a left ventricular (LV) aneurysm is largely determined by size and function of nonaneurysmal or residual myocardium. A residual myocardial index was determined using 2-dimensional echocardiography (2-D echo) in 56 consecutive patients scheduled for LV aneurysmectomy, and these results were correlated with surgical outcome. The index was calculated using 3 apical cross sections: the 2- and 4-chamber views and the long-axis view. These views were recorded at mutual angles of 60 °. In each view the end-diastolic length of normally moving endocardium of the 2 opposite walls was expressed as a fraction of the end-diastolic LV long axis. The index was assessed by averaging the 6 ratios obtained. In 41 survivors the index ranged from 40 to 71% (mean ± standard deviation 53 ± 7.8) and in 15 nonsurvivors from 29 to 67% (mean 38 ± 8.5, p < 0.01). With 1 exception, this echocardiographic index sharply separated survivors from nonsurvivors. The lower limit to survive aneurysmectomy was 40%.