Surgical treatment of left ventricular aneurysms: a comparison of long-term follow-up of left ventricular function for classic aneurysmectomy and endoaneurysmorrhaphy techniques.

Objective: Myocardial infarction may be complicated by the formation of a left ventricular (LV) aneurysm that distorts the normal elliptical geometry of the ventricle to produce a dilated spherical ventricle with limited contractile and filling capacities. One of the consequences is congestive heart failure, which may be refractory to medical therapy and require surgical treatment. The aim of this study was to evaluate LV function in the late term following repair of LV aneurysm.Methods: Ninety-seven patients underwent repair of postinfarctional LV aneurysms. Sixty-one patients (62.9%) underwent classic aneurysmectomy, and 36 patients (37.1%) had endoaneurysmorrhaphy. The mean age (±SD) of the 87 men (89.7%) and 10 women was 55.98 ± 8.59 years. Coronary surgery was performed in 82 patients (84.5%), with a mean of 1.34 ± 0.77 grafts/patient. The mean preoperative ejection fraction (EF) was 39.74% ± 8.79% (classic, 39.92% ± 8.90%; endoaneurysmorrhaphy, 39.43% ± 8.61%; difference not statistically significant [NS]). Fifty-five patients (56.7%) had angina of Canadian Cardiovascular Society class III to IV (classic, 55.7%; endoaneurysmorrhaphy, 58.3%; NS), 31 patients (31.9%) were in New York Heart Association (NYHA) class III to IV (classic, 31.1%; endoaneurysmorrhaphy, 33.3%; NS), and the mean preoperative NYHA functional class was 2.88 ± 0.74 (classic, 2.83 ± 0.77; endoaneurysmorrhaphy, 2.97 ± 0.71; NS).Results: The mortality rate at