[Surgical treatment of left ventricular aneurysms--midterm results with two types of repair--linear resection and endoventricular repair].

OBJECTIVES: The optimal surgical technique for correction of left ventricular aneurysms is still debated. This study compares the midterm results achieved with linear resection or endoventricular repair.

METHODS: In the period February 2002-February 2004 forty-five consecutive patients with anterior LVA have been operated. The patients were divided in two groups according to the applied surgical technique--Group-I endoventricular repair in 23 pts (52%) and Group-II linear resection in 22 pts (47%). The mean age was in the whole group was 65.4 years, of them 34 (75.6%) were man, 41 (91%) were in NYHA class III or IV, 31 (68.8%) with congestive heart failure and 35 (77.7%) with stenocardia. Bypass grafting was performed in 41 (93.3%), trombectomy of the left ventricle 18 (40%), mitral valvuloplasty in 4 (8.8%) and VSD closure in 1 (2.2%) patients.

RESULTS: Early mortality was 8.6% in Group-I and 9% in Group-II. Low cardiac output treated with IABP and catecholamines was present in 13 (28.8%) patients and there was one ischemic stroke and one revision for bleeding. Important reduction in the ventricular volumes (56 ml) and in the functional class (from 3.2 to 1.3 NYHA) were observed. The reduction in EDVI and ESVI and the increase in EF were significantly higher in Group-I than in Group-II and a trend for future improvement in Group-I was observed at follow-up.

CONCLUSIONS: Both surgical techniques show similar good results in terms of mortality, improvement of functional capacity and survival. Endoventricular reconstruction shows advantages in volume reduction, increase of EF and reshaping of the left ventricle.