Email updates

Keep up to date with the latest news and content from Journal of Cardiothoracic Surgery and BioMed Central.

Open Access Research article

Early results after surgical treatment of left Ventricular Aneurysm

Xisheng Wang1*, Xuezhi He2, Yunqing Mei1*, Qiang Ji1, Jing Feng1, Jianzhi Cai1, Yifeng Sun1 and Shiliang Xie1

Author Affiliations

1 The Department of Thoracic Cardiovascular Surgery, Tongji Hospital of Tongji University, 389 Xincun Road, Shanghai, 200065, China

2 The Department of Thoracic Cardiovascular Surgery, Dalian Municipal Central Hospital, 826 Southwest Road, Dalian, Liaoning, 116033, China

For all author emails, please log on.

Journal of Cardiothoracic Surgery 2012, 7:126  doi:10.1186/1749-8090-7-126

Published: 21 November 2012

Abstract

Background

Left ventricular aneurysm (LVA) is a serious complication of myocardial infarction and reduces the chances of survival. Controversy still exists regarding the optimal surgical technique for LVA repair. We analyze the efficacy of two techniques, linear vs. endoventricular circular patch plasty, for repair of LVA and the efficacy of surgical ventricular restoration (SVR) on beating heart.

Methods

This study included 62 patients who underwent SVR from 1086 consecutive patients were subjected to coronary artery bypass grafting (CABG) between 2000 and 2009. All selected patients were divided either into group liner or patch according to the choice of the repair technique depended on factors such as localization, size and dimension of the scar. The patients also were divided either into group beating heart or cardioplegia. The pre-, intra- and postoperative relevant data of all selected patients were analyzed.

Results

The mortality was not significantly different between linear and patch repair groups, also the actuarial survival rates within 24 months (p= 0.529). Postoperative echocardiographic findings showed significant improvements in left ventricular function in both groups. The beating heart technique reduced postoperative peak release by 27% for Cardiac troponin I (cTnI) compared with the cardioplegia group (0.46 ± 0.06 ng/mL versus 0.63 ± 0.09 ng/mL, p= 0.004), and increased the perioperative survival by 9% (97.2% versus 88.5%), but the actuarial survival rates were not significantly different between the groups from 2 to 24 months (p= 0.151).

Conclusions

Both techniques (linear and patch) achieved good results with respect to mortality, functional status and survival. The choice of surgical technique should be adapted in each patient. The beating heart technique may to some extent relieve myocardial injury in patients undergoing SVR.

Keywords:
Left ventricular aneurysm; Liner repair; Endoventricular circular patch plasty; Beating heart