Repair of left ventricular pseudoaneurysm using primary closure, Dacron, or pericardial patches yielded similar outcomes with 27.3% hospital mortality, though pericardial patches had less arrhythmia.
Observational (n=22)
Does the method of surgical repair (primary closure, Dacron patch, or pericardial patch) affect outcomes in patients with left ventricular pseudoaneurysm after myocardial infarction?
In a retrospective analysis of 22 patients, three techniques for left ventricular pseudoaneurysm repair yielded similar mortality and functional outcomes, though autologous pericardial patches may offer an advantage in reducing postoperative arrhythmias.
The outcomes of 3 different methods of repair of left ventricular pseudoaneurysm after myocardial infarction were analyzed retrospectively. The operations were carried out in 22 patients between 1985 and 2008. Repair procedures included primary closure with Teflon-pledgeted sutures, and Dacron or pericardial patches. Overall hospital mortality was 27.3% (2 patients had primary closure, 3 had a Dacron patch, and 1 had a pericardial patch). Mean postoperative bleeding was 885 mL (range, 200-4,800 mL). Mean preoperative and postoperative ejection fractions were 40% (30%-47%) and 48% (30%-65%), respectively. The overall incidence of arrhythmia was 36.4% (8 patients). The incidence of arrhythmia was lowest in the pericardial patch group, but this was not statistically significant. No significant differences in postoperative ejection fraction or hemorrhage were found among the study groups. Mean survival was 61.9 + or - 41.4 months in the 16 hospital survivors. Although the 3 techniques gave similar results, repair with an autologous pericardial patch may offer an advantage in terms of less postoperative arrhythmias.
Fedakar et al. (Mon,) conducted a observational in Left ventricular pseudoaneurysm after myocardial infarction (n=22). Repair procedures (primary closure, Dacron patch, or pericardial patch) vs. Compared among the 3 techniques was evaluated on Overall hospital mortality. Repair of left ventricular pseudoaneurysm using primary closure, Dacron, or pericardial patches yielded similar outcomes with 27.3% hospital mortality, though pericardial patches had less arrhythmia.