Key result
Posterior left ventricular aneurysms were significantly associated with higher perioperative mortality following endoaneurysmorrhaphy compared to antero-septal aneurysms (p=0.017).
Why the study?
Does the location of the aneurysm (posterior vs. antero-septal) affect perioperative mortality in patients undergoing endoaneurysmorrhaphy?
Cohort (n=158)
Does the location of the aneurysm (posterior vs. antero-septal) affect perioperative mortality in patients undergoing endoaneurysmorrhaphy?
p-value: p=0.017
Posterior LV aneurysms are associated with higher perioperative mortality during endoaneurysmorrhaphy, though this may be driven by worse baseline disease severity.
Posterior LV aneurysms were associated with higher perioperative mortality; leaves open whether location independently predicts risk versus baseline severity.
Endoaneurysmorrhaphy is mostly performed on anterior-septal left ventricular (LV) aneurysms. It may also be applied to posterior aneurysms, which is technically more challenging. Whether the surgical risk is the same, irrespective of the location of the aneurysm, has not been studied before. We reviewed our experience with 158 patients (62+/-9 years, 72% male) undergoing endoaneurysmorrhaphy. Eleven patients (7%) had posterior LV aneurysms. Perioperative mortality was 5.7%. Of all preoperative and surgical variables tested, the presence of a posterior LV aneurysm (p=0.017), concomitant mitral valve surgery (p=0.008) and duration of extracorporal circulation (p=0.001) were significantly associated with higher perioperative mortality. However, patients with posterior LV aneurysms had more severe heart failure (p=0.0061) and a higher LV end diastolic volume index (138+/-38 vs. 102+/-41 ml/kg body weight; p=0.040) than patients with antero-septal LV aneurysms. Further studies are needed to determine whether the location of the aneurysm is a risk factor for mortality irrespective of the clinical presentation.
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Matthias Bechtel (2003) conducted a cohort in Left ventricular aneurysms (n=158). Posterior left ventricular aneurysm vs. Antero-septal left ventricular aneurysm was evaluated on Perioperative mortality (p=0.017). Posterior left ventricular aneurysms were significantly associated with higher perioperative mortality following endoaneurysmorrhaphy compared to antero-septal aneurysms (p=0.017).
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