ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
EFFECTIVENESS OF LEFT VENTRICULAR ANEURYSM REPAIRS AND THE ANALYSIS OF RISK FACTORS
Fatih İSMAİLOĞLU, Mustafa ÖZBARAN, Münevver YÜKSEL, Suat BUKET, Ali TELLİ, İsa DURMAZ
Ege Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Ana Bilim Dalı, İzmir

Background: Our study was designed to evaluate the early and mid-term follow-up results of patients who underwent left ventricular aneurysm repair, the effectiveness of different techniques, and to determine the risk factors affecting postoperative outcome.

Methods: Between 1997 and 1999, 41 patients underwent left ventricular aneurysm repair. Echocardiographic evaluations of left ventricular ejection fraction (LVEF) were performed preoperatively, postoperatively, and at mean follow-up of 33.74 ± 7.22 months. Thirty-seven (90.2%) patients had anteroapical aneurysm, and 4 (9.8%) had posterobasal aneurysm. Endoaneurysmorraphy and linear repair techniques were employed in 28 (68.3%) and 13 (31.7%) of patients, respectively. As preoperatively, only 6 (14.6%) patients were in NYHA class I, 28 (68.3%) patients were in digoksin management, and the mean LVEF was 33.39% ± 5.97%.

Results: The overall mortality was 2 (4.9%) patients. Postoperative morbidities were observed in 21 (51.2%) patients. The most frequent complication observed in 13 (31.7%) patients was serious ventricular arrhythmia. Thirty-five (89.7%) of surviving 39 (95.1%) patients were in NYHA class I. Patients in digoksin management lowered to 7 (17.9%), and the mean LVEF raised to 43.31% ± 4.26%. The improvements in functional capacity and LVEF were significant. Multivariate analysis revealed that number (³ 2) of concomittantly revascularized coronary arteries was an independent risk factor (p = 0.0443). The follow-up NYHA classification of patients who underwent endoaneurysmorraphy (1.037 ± 0.192) was better than that of patients who underwent linear repair (1.33 ± 0.651) (p = 0.043).

Conclusion: We consider that left ventricular aneurysm repairs provide satisfactory improvements in functional capacity with low mortality and morbidity; number of revascularized coronary arteries, thereby, multivessel coronary disease is an important risk factor, and endoaneurysmorraphy seem better in long-term functional improvement.

Keywords : Left ventricular aneurysm, linear repair, endoaneurysmorraphy
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