engleski

Long-term results after reconstructive surgery for aneurysms of the left ventricle

OBJECTIVES: Reconstruction of the left ventricle (LV) in patients with left ventricle aneurysm (LVA) allows physiological remodeling of LV with general improvement of heart function. We present our experience in LV remodeling and long-term follow-up results. PATIENTS AND METHODS: From 5/1998 to 1/2006, 39 patients with LVA underwent reconstructive procedure. Sixteen patients (41%) had reduced systolic function of the left ventricle (EF<35%). An average EF was 42.5±15.6% (20-70). Mean additive EuroScore was 6.3±4.1 (3- 20) and logistic mortality 11.4±21.3% (2.3%-86.3%). Majority of patients preoperatively was in NYHA functional class II (44%), and 7 patients (20%) were in NYHA class III or IV. LV reconstruction after aneurysmectomy was performed using endoventricular patch technique, and in 5 patients with smaller aneurysms by means of linear closure. In 34 patients (87%) concomitant myocardial revascularization was performed. Additionally, in 6 patients (15%), mitral valve procedure (repair in 5 patients and replacement in 1) was carried out. RESULTS: Hospital mortality was 5.1% (2 patients). There were no perioperative myocardial infarctions. In 2 patients (5%), an episode ventricular fibrillation was observed. Long-term follow-up was completed by means of phone interview with an average duration of 23.5±25.7 months (0-90). Drop-out was 5.4% (2 patients). There were 3 deaths (8.6%) during follow-up. Twenty seven patients (77%) were in NYHA functional class I and only one patient (3%) was in NYHA class III. CONCLUSION: LV remodeling is a safe surgical procedure with low perioperative mortality and excellent long term results, in terms of both survival and functional status.

left ventricle aneurysm

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