Management of ventricular aneurysms following myocardial infarction

Aneurysmectomy is the most effective form of therapy for patients with symptomatic aneurysms of the left ventricle following myocardial infarction. Operation should not be undertaken less than 2 months following myocardial infarction unless there is severe hemodynamic derangement. Circulatory assist devices, such as the intra‐aortic balloon pump, have been of particular help in this group of severely ill patients. Results of elective aneurysmectomy performed 2 months or more following myocardial infarction are quite good, with the long‐term outlook for the patient generally depending on the function of the uninvolved myocardium and the status of the remaining coronary circulation. When ventricular irritability results in life‐threatening arrhythmia, aneurysmectomy must often be performed. The results in this group of patients have been somewhat disappointing, but newer techniques of localizing irritable foci may result in the development of more effective surgical procedures .