[The results of surgical treatment of post-infarction left ventricular aneurysms]

The surgical results of post-infarction left ventricular aneurysmectomy have been evaluated in 24 patients approximately 1 year after operation. In 20 patients coronary artery bypass grafting (CABG) was also carried out. In 8 patients mechanical circulatory assist such as intra-aortic balloon pump (IABP) or left ventricular assist device (LVAD) was undertaken for the purpose of weaning from cardiopulmonary bypass. Postoperative left ventricular function, such as ejection fraction and cardiac index, and classification of the New York Heart Association were improved significantly after aneurysmectomy. However, postoperative improvement of these parameters was not remarkable in cases of poor preoperative left ventricular function. Preoperative left ventricular function revealed to be poor in multiple vessel disease, and concomitant coronary artery bypass grafting with aneurysmectomy can be performed with good long-term results and significant improvements of postoperative cardiac function. In patients that had showed the end-diastolic perimeter more than 40% and the shortening rate of transverse axis at the left ventricular base less than 20%, postoperative improvement of cardiac function revealed unsatisfactory. Mechanical circulatory assist showed lifesaving effect, but in cases that required IABP or LVAD postoperative cardiac function has not improved significantly.