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Left ventricular aneurysmectomy with geometric reconstruction: surgical aspects and immediate results

The early results of 79 patients who underwent left ventricular aneurysmectomy with the geometric and circular reconstruction in a seven years experience are analyzed. The most common indication for operation was congestive heart failure (78.4%), isolated (25.3%) or with coronary artery disease (53.1%). Sixty (76%) patients were in NYHA class III and 10 (12.6%) in NYHA class IV at the time of surgery. Fifty eight (73.4%) underwent coronary artery bypass graft surgery. Hospital mortality was 5.1% and patients older than 60 (12%), in NYHA class IV (20%), with poor left ventricular function (FE < 0.30 - 20% and LVEDP > 25 - 14%) and extensive coronary artery disease (10%) were under increased risk. Low cardiac output and use of IABP were also associate with this risk factors. Other factors of increased risk pointed in the literature are discussed. There were no deaths for isolated left ventricular aneurysmectomy. The early results of this study and the early and late results from others using the same technique are better than that obtained by others with different types of correction and they suggest that this is the procedure of choice to treat left ventricular aneurysm.

aneurysms of left ventricle; aneurysms of left ventricle


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