Author + information
- Received November 23, 1982
- Revision received January 27, 1983
- Accepted March 18, 1983
- Published online July 1, 1983.
- Stephen K. Kiefer, MD,
- Greg C. Flaker, MD*,
- Richard H. Martin, MD, FACC and
- Jack J. Curtis, MD, FACC
- ↵*Address for reprints: Greg Flaker, MD, Department of Cardiology C-7, University of Missouri, Health Science Center, Columbia, Missouri 65212.
Surgical repair of a left ventricular aneurysm is associated with significant perioperative mortality and substantial mortality in the first 2 years after operation. In a retrospective review of 42 patients undergoing repair of an anteroapical aneurysm, two cardiac catheterization variables were identified that predicted a good surgical outcome, defined as perioperative survival and improved functional status. Specifically, patients with an ejection fraction of the contractile section (nonaneurysmal) of the left ventricle of 35% or greater and a left ventricular end-diastolic pressure of 25 mm Hg or less had a low perioperative mortality rate (6.5%), experienced no late mortality and had sustained clinical improvement of at least one New York Heart Association functional class (93.5%). In contrast, patients with a contractile section ejection fraction of less than 35% or a left ventricular end-diastolic pressure greater than 25 mm Hg had a higher perioperative mortality rate (27.3%), experienced a substantial late mortality rate (27.3%) or had no significant functional class improvement (9%); only 36.4% had sustained clinical improvement.
This study suggests that the postoperative results of left ventricular aneurysm repair are dependent on the hemodynamic status of the nonresected left ventricle.
- Received November 23, 1982.
- Revision received January 27, 1983.
- Accepted March 18, 1983.
- American College of Cardiology Foundation