Surgical Management of Left Ventricular Aneurysms by Endoventricular Pericardial Patch Plasty

Background: Early and late surgical outcomes of endocardial resection and aneursymectomy repaired with an autologous pericardial patch were studied. Methods: We studied 125 patients who underwent endoaneurysmorrhaphy with pericardial patch during the period from June 1993 until June 2000. Preoperative, early and late postoperative results, annual postoperative echocardiography of all patients and hemodynamic controls of 35 patients within a mean follow-up of 64±8 months were analyzed. Results: Mean NYHA improved to postoperative 2.1±0.5 from preoperative 2.8±0.4. Mean number of bypass grafts was 2.6±1.1. Left ventricular ejection fraction rate improved to 36.2±8% in one month. 39.3±9% in 6 months, 42.3±8% in one year versus preoperative 29.2±9% (P≤0.05). Perioperative mortality was 6.4% (eight patients) and 11 deaths were observed in the late follow-up (9.4%). Conclusion: Endoaneurysmorrhaphy with pericardial patch may be an alternative option in the management of left ventricular aneurysms within acceptable surgical results.

[1]  K. Yano,et al.  Left ventricular aneurysm without coronary artery disease, incidence and clinical features: clinical analysis of 11 cases. , 2000, Internal medicine.

[2]  S. Surakiatchanukul.  Repair of the left ventricular aneurysm: twenty-two years of experience with long-term results. , 1999, Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.

[3]  O. Taşdemír,et al.  Coronary artery bypass grafting on the beating heart without the use of extracorporeal circulation: review of 2052 cases. , 1998, The Journal of thoracic and cardiovascular surgery.

[4]  G. Melina,et al.  Left ventricular aneurysmectomy; comparison between two techniques; early and late results. , 1997, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[5]  A. Toso,et al.  Akinetic versus dyskinetic postinfarction scar: relation to surgical outcome in patients undergoing endoventricular circular patch plasty repair. , 1997, Journal of the American College of Cardiology.

[6]  R. Shemin,et al.  Repair of left ventricular aneurysm: long-term results of linear repair versus endoaneurysmorrhaphy. , 1997, The Annals of thoracic surgery.

[7]  D. Bogen,et al.  Repair of left ventricular aneurysm. Changes in ventricular mechanics, hemodynamics, and oxygen consumption. , 1992, The Journal of thoracic and cardiovascular surgery.

[8]  A. Jatene.  Left ventricular aneurysmectomy. Resection or reconstruction. , 1985, The Journal of thoracic and cardiovascular surgery.

[9]  K. G. Looser,et al.  Infection of cardiac suture line after ventricular aneurysmectomy. Report of two cases. , 1976, The Journal of thoracic and cardiovascular surgery.

[10]  M. Allen,et al.  As originally published in 1988: The use of autologous pericardium for ventricular aneurysm closure. Updated in 1996. , 1996, The Annals of thoracic surgery.

[11]  D A Cooley,et al.  Ventricular endoaneurysmorrhaphy: results of an improved method of repair. , 1989, Texas Heart Institute journal.