Endoventricular patch plasty resulted in 0% hospital mortality compared to 10.3% with conventional aneurysmectomy (P>0.05), and significantly less low cardiac output syndrome (9.7% vs 36.8%, P=0.01).
Cohort (n=118)
Does endoventricular patch plasty improve early and late clinical and echocardiographic outcomes compared to conventional aneurysmectomy in patients with postinfarction left ventricular aneurysm?
Endoventricular patch plasty combined with complete myocardial revascularization yields better clinical and echocardiographic outcomes than conventional aneurysmectomy for postinfarction left ventricular aneurysms.
Absolute Event Rate: 0% vs 10.3%
p-value: p=>0.05
OBJECTIVE: The aim of the present study was to evaluate early and late results of two different surgical techniques for left ventricular aneurysms repair. The conventional aneurysmectomy and direct closure of the ventricular wall and the endoventricular patch plasty. METHODS: We retrospectively reviewed 118 patients operated on for postinfarction left ventricular aneurysm from 1981 to 1994. Eighty-seven patients (Group A) were operated upon between 1981 and 1991 with the conventional technique and 31 patients (Group B) between 1992 and 1994 with the endoventricular patch plasty technique. Preoperative clinical, hemodynamic and echocardiographic evaluation with operative procedures and early postoperative results of all patients are reported. We also analyzed results of late clinical and echocardiographic controls of 34 patients of Group A and all patients of Group B after a mean follow-up of 42 and 28 months, respectively. RESULTS: Mean number of by-pass grafts was 1.9 in Group A and 2.6 in Group B (P = 0.01). The left anterior descending coronary artery was revascularized in 27 patients of Group A (34.6%) and 26 of Group B (89.7%) (P 0.05). Thirty-two patients of Group A (36.8%) and 3 of Group B (9.7%) suffered of low cardiac output syndrome (P = 0.01). At late control, improvements observed in NYHA and CCS classes, left ventricular ejection fraction (all P 0.05 in Group A and P < 0.001 in Group B) proved to be statistically higher in patients of Group B. CONCLUSIONS: Endoventricular patch plasty associated with a complete myocardial revascularization, in particular of the anterior descending coronary, and a larger use of the internal mammary artery, permits, by means of reconstruction of the left ventricular geometry, a better outcome for patients undergoing left ventricular aneurysmectomy.
Roberta Sinatra (Fri,) conducted a cohort in Postinfarction left ventricular aneurysm (n=118). Endoventricular patch plasty vs. Conventional aneurysmectomy and direct closure was evaluated on Hospital mortality (p=>0.05). Endoventricular patch plasty resulted in 0% hospital mortality compared to 10.3% with conventional aneurysmectomy (P>0.05), and significantly less low cardiac output syndrome (9.7% vs 36.8%, P=0.01).