Surgical Treatment of Left Ventricular Aneurysm_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 YANGWen-gang , XUESong , HUANGRi-tai , LIANFeng , XUGen-xing

Department of Cardiovascular Surgery, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai 200127, P. R. China;

Corresponding author：

YANGWen-gang, Email: xuesong64@163.com

Keywords：

Left ventricular aneurysm; Ventricular aneurysm resection; Left ventricular reconstruction; Linear repair

DOI：

10.7507/1007-4848.20150058

Video：

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Objective To evaluate the effects of modified left ventricular reconstruction (LVR) and linear repair (LR) to post-infarct left ventricular aneurysm (LVA) and summarize the surgical experience of LVA. Methods From May 2004 to December 2011, 47 patients were admitted in the Department of Cardiovascular Surgery, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University. There were 25 patients underwent LVR (group LVR, including 21 males and 4 females), 18 patients underwent LR (group LR, including 14 males and 4 females) and 4 patients underwent directly sutured (including 3 males and 1 female). Among them, 42 patients underwent coronary artery bypass grafting (CABG). During 6-24 months'follow-up, left ventricular ejection fraction (LVEF), quality of life and activity were measured. Results Postoperative LVEF was significantly higher than preoperative LVEF in group LVR(49.2%±13.6% vs. 32.5%±12.9%, P < 0.05) and group LR (47.5%±11.6% vs. 36.9%±11.6%, P < 0.05). One patient died in LR group (5.5%) and 1 died in LVR group (4.0%), no death occurred in directly sutured surgery. Total mortality was 4.2%. Conclusion LVR and LR are both effective treatment for LVA. Personalized treatment can receive satisfactory short-and long-term outcomes.

Citation： YANGWen-gang, XUESong, HUANGRi-tai, LIANFeng, XUGen-xing. Surgical Treatment of Left Ventricular Aneurysm. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 202-205. doi: 10.7507/1007-4848.20150058 Copy

1.	Mills NL, Everson CT, Hockmuth DR, et al.Technical advances in the treatment of left ventricular aneurysm.Ann Thorac Surg, 1993, 55(4):792-800.
2.	Cooley DA, Collins HA, Morris GC, et al.Ventricular aneurysm after myocardial infarction.Surgical excision with use of temporary cardiopulmonary bypass.JAMA, 1958, 167(114):557.
3.	Jatene AD.Left ventricular aneurysmectomy:resection or reconstruction.J Thorac Cardiovasc Surg, 1985, 89(2):321.
4.	Lundblad R, Abdelnoor M, Svennevig JL.Repair of left ventricular aneurysm:surgical risk and long-term survival.Ann Thorac Surg, 2003, 76(3):719-725.
5.	Sinatra R, Macrina F, Braccio M, et al.Left ventricular aneurysmec-tomy; comparison between two techniques; early and late results.Eur J Cardiothorac Surg, 1997, 12(2):291-297.
6.	Doss M, Martens S, Sayour S, et al.Long term follow-up of left ventricular function after repair of left ventricular aneurysm.A comparison of linear closure versus patch plasty.Eur J Cardiothorac Surg, 2001, 20(4):783-785.
7.	Vural KM, Sener E, Ozatik MA, et al.Left ventricular aneurysm repair:an assessment of surgical treatment modalities.Eur J Cardiothorac Surg, 1998, 13(1):49-56.
8.	Antunes PE, Silva R, Ferrao de Oliveira J, et al.Left ventricular aneurysms:early and long-term results of two types of repair.Eur J Cardiothorac Surg, 2005, 27(2):210-215.
9.	Mangschau A.Akinetic versus dyskinetic left ventricular aneurysms diagnosed by gated scintigraphy:difference in surgical outcome.Ann Thorac Surg, 1989, 47(5):746-751.
10.	Mickleborough LL, Maruyama H, Liu P, et al.Results of left ventricular aneurysmectomy with a tailored scar excision and primary closure technique.J Thorac Cardiovasc Surg, 1994, 107(3):690-698.
11.	Likoff W, Bailey CP.Ventriculoplasty:excision of myocardial aneurysm.Report of a successful case.J Am Med Assoc, 1955, 158(11):915-920.
12.	Tavakoli R, Bettex D, Weber A, et al.Repair of postinfarction dyskinetic LV aneurysm with either linear or patch technique.Eur J Cardiothorac Surg, 2002, 22(1):129-134.
13.	Coskun KO, Popov AF, Coskun ST, et al.Surgical treatment of left ventricular aneurysm.Asian Cardiovasc Thorac Ann, 2009, 17(5):490-493.
14.	Di Mattia DG, Di Biasi P, Salati M, et al.Surgical treatment of left ventricular post-infarction aneurysm with endoventriculoplasty:late clinical and functional results.Eur J Cardiothorac Surg, 1999, 15(4):413-418.
15.	王玺胜, 何学志, Devi Shetty.左心室室壁瘤的外科治疗.中国胸心血管外科临床杂志, 2004, 11(4):290-291.
16.	Mukaddirov M, Demaria RG, Perrault LP, et al.Reconstructive surgery of postinfarction left ventricular aneurysms:techniques and unsolved problems.Eur J Cardiothorac Surg, 2008, 34(2):256-261.
17.	Pasini S, Gagliardotto P, Punta G, et al.Early and late results after surgical therapy of postinfarction left ventricular aneurysm.J Cardiovasc Surg (Torino), 1998, 39(2):209-215.
18.	Vauthey JN, Berry DW, Snyder DW, et al.Left ventricular aneurysm repair with myocardial revascularization:an analysis of 246 consecutive patients over 15 years.Ann Thorac Surg, 1988, 46(1):29-35.
19.	Mickleborough LL, Carson S, Ivanov J.Repair of dyskinetic or akinetic left ventricular aneurysm:results obtained with a modified linear closure.J Thorac Cardiovasc Surg, 2001, 121(4):675-682.
20.	Zheng Z, Fan H, Feng W, et al.Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques.Interact Cardiovasc Thorac Surg, 2009, 9(3):431-436.
21.	甘辉立, 张健群, 赵映, 等.心肌梗死后左心室假性室壁瘤的诊断与外科治疗.中国胸心血管外科临床杂志, 2008, 15(2): 87-91.

1. Mills NL, Everson CT, Hockmuth DR, et al.Technical advances in the treatment of left ventricular aneurysm.Ann Thorac Surg, 1993, 55(4):792-800.
2. Cooley DA, Collins HA, Morris GC, et al.Ventricular aneurysm after myocardial infarction.Surgical excision with use of temporary cardiopulmonary bypass.JAMA, 1958, 167(114):557.
3. Jatene AD.Left ventricular aneurysmectomy:resection or reconstruction.J Thorac Cardiovasc Surg, 1985, 89(2):321.
4. Lundblad R, Abdelnoor M, Svennevig JL.Repair of left ventricular aneurysm:surgical risk and long-term survival.Ann Thorac Surg, 2003, 76(3):719-725.
5. Sinatra R, Macrina F, Braccio M, et al.Left ventricular aneurysmec-tomy; comparison between two techniques; early and late results.Eur J Cardiothorac Surg, 1997, 12(2):291-297.
6. Doss M, Martens S, Sayour S, et al.Long term follow-up of left ventricular function after repair of left ventricular aneurysm.A comparison of linear closure versus patch plasty.Eur J Cardiothorac Surg, 2001, 20(4):783-785.
7. Vural KM, Sener E, Ozatik MA, et al.Left ventricular aneurysm repair:an assessment of surgical treatment modalities.Eur J Cardiothorac Surg, 1998, 13(1):49-56.
8. Antunes PE, Silva R, Ferrao de Oliveira J, et al.Left ventricular aneurysms:early and long-term results of two types of repair.Eur J Cardiothorac Surg, 2005, 27(2):210-215.
9. Mangschau A.Akinetic versus dyskinetic left ventricular aneurysms diagnosed by gated scintigraphy:difference in surgical outcome.Ann Thorac Surg, 1989, 47(5):746-751.
10. Mickleborough LL, Maruyama H, Liu P, et al.Results of left ventricular aneurysmectomy with a tailored scar excision and primary closure technique.J Thorac Cardiovasc Surg, 1994, 107(3):690-698.
11. Likoff W, Bailey CP.Ventriculoplasty:excision of myocardial aneurysm.Report of a successful case.J Am Med Assoc, 1955, 158(11):915-920.
12. Tavakoli R, Bettex D, Weber A, et al.Repair of postinfarction dyskinetic LV aneurysm with either linear or patch technique.Eur J Cardiothorac Surg, 2002, 22(1):129-134.
13. Coskun KO, Popov AF, Coskun ST, et al.Surgical treatment of left ventricular aneurysm.Asian Cardiovasc Thorac Ann, 2009, 17(5):490-493.
14. Di Mattia DG, Di Biasi P, Salati M, et al.Surgical treatment of left ventricular post-infarction aneurysm with endoventriculoplasty:late clinical and functional results.Eur J Cardiothorac Surg, 1999, 15(4):413-418.
15. 王玺胜, 何学志, Devi Shetty.左心室室壁瘤的外科治疗.中国胸心血管外科临床杂志, 2004, 11(4):290-291.
16. Mukaddirov M, Demaria RG, Perrault LP, et al.Reconstructive surgery of postinfarction left ventricular aneurysms:techniques and unsolved problems.Eur J Cardiothorac Surg, 2008, 34(2):256-261.
17. Pasini S, Gagliardotto P, Punta G, et al.Early and late results after surgical therapy of postinfarction left ventricular aneurysm.J Cardiovasc Surg (Torino), 1998, 39(2):209-215.
18. Vauthey JN, Berry DW, Snyder DW, et al.Left ventricular aneurysm repair with myocardial revascularization:an analysis of 246 consecutive patients over 15 years.Ann Thorac Surg, 1988, 46(1):29-35.
19. Mickleborough LL, Carson S, Ivanov J.Repair of dyskinetic or akinetic left ventricular aneurysm:results obtained with a modified linear closure.J Thorac Cardiovasc Surg, 2001, 121(4):675-682.
20. Zheng Z, Fan H, Feng W, et al.Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques.Interact Cardiovasc Thorac Surg, 2009, 9(3):431-436.
21. 甘辉立, 张健群, 赵映, 等.心肌梗死后左心室假性室壁瘤的诊断与外科治疗.中国胸心血管外科临床杂志, 2008, 15(2): 87-91.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment of Left Ventricular Aneurysm

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