Key result
Left ventricular aneurysmectomy yielded a 57% cumulative 5-year survival, with preoperative EF ≥0.30 associated with 76% survival compared to 31% for EF <0.30.
Why the study?
Does left ventricular aneurysmectomy improve survival and clinical symptoms in patients with postinfarction left ventricular aneurysm?
Cohort (n=57)
Does left ventricular aneurysmectomy improve survival and clinical symptoms in patients with postinfarction left ventricular aneurysm?
Left ventricular aneurysmectomy improves clinical symptoms and LVEF, with better long-term survival observed in patients with a preoperative EF ≥ 0.30.
Left ventricular aneurysmectomy was performed on 45 men and 12 women (mean age 57 years) during a 12-year period. The hospital mortality was 14% and the cumulative 5-year survival 57% +/- 9 (SE). Of 35 survivors, 33 underwent a follow-up study (mean 28 months post-operatively). The mean cardiothoracic index fell from 0.58 +/- 0.08 (SD) to 0.51 +/- 0.04 and the mean left ventricular ejection fraction (EF) improved from 0.30 +/- 0.08 to 0.38 +/- 0.01 (both changes significant). Echocardiographic parameters showed no significant improvement in left ventricular function. The NYHA classification was I or II in 85% of the patients at follow-up, but in only 23% preoperatively. Preoperative EF greater than or equal to 0.30 was associated with 76% +/- 16 (SE) cumulative 5-year survival as compared with 31% +/- 12 when EF had been less than 0.30. In view of these results, left ventricular aneurysmectomy should be recommended for all symptomatic patients.
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Knudsen et al. (1987) conducted a cohort in Postinfarction Left Ventricular Aneurysm (n=57). Left ventricular aneurysmectomy was evaluated on Cumulative 5-year survival. Left ventricular aneurysmectomy yielded a 57% cumulative 5-year survival, with preoperative EF ≥0.30 associated with 76% survival compared to 31% for EF <0.30.
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