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.