ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical treatment of postinfarction left ventricular aneurysms: a comparison between patch and linear techniques
Necip Becit1, Bilgehan Erkut1, Münacettin Ceviz1, Yahya Ünlü1, Şakir Aslan2, Serpil Mevriye Diler1, Hikmet Koçak1
1Atatürk Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Erzurum
2Atatürk Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum
Background: We evaluated early clinical results and echocardiographic measurements of the left ventricle in patients who underwent left ventricular aneurysm repair using two different techniques along with myocardial revascularization.

Methods: Thirty-nine patients (27 males, 12 females; mean age 58±9 years; range 33 to 80 years) underwent postinfarction left ventricular aneurysm repair and myocardial revascularization performed by the same surgical team within a ten-year period. Ventricular reconstruction was performed using endoventricular circular patch plasty (Dor procedure) (n=24) or linear repair technique (n=15). The two groups were compared with respect to clinical data and echocardiographic parameters obtained preoperatively and postoperatively, and at the end of a mean follow-up of one year.

Results: The two groups were similar with respect to age, gender, risk factors, and concomitant procedures. All the patients had significant left anterior descending coronary artery stenosis, and all underwent coronary artery bypass grafting. The mean number of grafts per patient was 2.08 with the Dor procedure and 2.13 with the linear repair technique. Hospital mortality occurred in 4.2% and 6.7% in the two groups, respectively (p>0.05). Echocardiographic parameters showed significant postoperative improvement in left ventricular functions in both groups (p<0.001). However, patients treated with the Dor procedure exhibited significantly better improvement in left ventricular systolic functions and NYHA functional class compared to those treated with the linear repair technique (p<0.05).

Conclusion: Our results demonstrate that postinfarction left ventricular aneurysm repair can be performed with both techniques with an acceptable surgical risk and with satisfying hemodynamic improvement. However, ventricular restoration performed by the Dor procedure is associated with better results in left ventricular systolic function and NYHA functional class of the patients.

Keywords : Cardiac surgical procedures; heart aneurysm/surgery; myocardial revascularization; ventricular function, left
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