ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
The Effect of Aneurysmectomy on Operative Mortality in Angiographically Akinetic and Dyskinetic Left Ventricular Aneurysms
Ufuk DEMİRKILIÇ, Erkan KURALAY, Ahmet T. YILMAZ, Ertuğrul ÖZAL, Hakan BİNGÖL, Harun TATAR, Ömer Y. ÖZTÜRK
Gülhane Askeri Tıp Akademisi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara
Left ventricular aneurysmectomy and plication were performed 55 of 63 patients who had left ventricular aneurysm in the Cardiovascular department of Gülhane Military Medical Academy (GATA) between 1991 and 1995. These aneurysms were separated angiographically into two groups on the basis of wall motion. GROUP (I) consisted of 21 patients whose aneurysms were akinetic and GROUP (II) consisted of patients whose aneurysms were dyskinetic, Akinetic aneurysms were most frequently seen in elderly patients with three-vessel disease and were noticed to involve more than one ventricular segment, while dyskinetic aneurysms were seen in younger patients with one-vessel disease and in- volve one ventricular segment. The cumulative operative mortality was 28.5 % (n=6) in group I and 2% (n=1) in group II. Operative mortality was over 50% in patients whose left ventricular end-diastolic pressure (LVEDP) was greater than 20 mmHg in group I. Eight patients whose LVEDP was over 20 mmHg in group I, underwent isolated coronary artery by-pass grafting, with an operative mortality of 12.5 % (n=1). in view of these findings, we believe that isolated myocardial revascularization will greatly reduce operative mortality in patients with akinetic aneurysms when LVEDP over 20 mmHg.
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