Short and Long-Term Results of Surgical Treatment of Left Ventricular Aneurysm

Although surgical treatment of left ventricular aneurysms has being performed for a long time, it is stili apoint of debate. In this study, we investigated hundred and fifty-nine patients who had been treated with surgery fo r left ventricular aneurysm in our clinic between years ı 985 to 1994. Perioperatuar mortality, long term survival ra tes and parameters which probably affect those ratios were evaluated. Eighty-five patients had three (53.5% ), 50 patients had two (3 1.4%), 20 patients had single (12.6%) vessel disease. In four patients, there were not any critica! lesion in coronary arteries. Classic linear repair in ı ı 1 cases, pıication in 46 cases and Dor plasty in two patients were performed. Revascularisation procedure was also performed in 140 (88%) cases. Average number of distal anastomosis was 2.6. Twenty cases (12.6%) died in perioperatuar period. The most important parameter which affect early mortality was the requirement of intra aortic balloon pump in the postoperative period. Mean duration time for follow-up was 47 months. Fourty-two Iate deaths occurred in this period. The overall 5-year survival rate was 71%. Predictors for long terın mortality were related to left ventricular function preoperatively; presence of congestive heart failure (p=0.02), poor functional capacity (p=0.036). Types of surgery (linear repair or plication) did not affect short and long term survival. Functional capacity of the survivors was improved. In conclusion, surgical treatment of left ventricul ar aneurysms with dassic linear repair and plication has acceptable short and long term survival rates and improves functional capacity. Either for early or for Iate postoperative period the most important predictor of survival is preoperative left ventricular function.