Principles of surgical treatment of post-infarction left ventricular aneurysms

Plechev V.V.; Yunusov V.M.; Sagatdinov T.Sh.; Prudko E.L.; Abbazov I.U.

doi:https://doi.org/10.17116/kardio202215051477

Plechev V.V.

Republican Cardiology Center

Yunusov V.M.

Republican Cardiology Center

Sagatdinov T.Sh.

Republican Cardiology Center

Prudko E.L.

Republican Cardiology Center

Abbazov I.U.

Republican Cardiology Center

Principles of surgical treatment of post-infarction left ventricular aneurysms

Authors:

Plechev V.V., Yunusov V.M., Sagatdinov T.Sh., Prudko E.L., Abbazov I.U.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(5): 477‑483

DOI: 10.17116/kardio202215051477

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To cite this article:

Plechev VV, Yunusov VM, Sagatdinov TSh, Prudko EL, Abbazov IU. Principles of surgical treatment of post-infarction left ventricular aneurysms. Russian Journal of Cardiology and Cardiovascular Surgery. 2022;15(5):477‑483. (In Russ.)
https://doi.org/10.17116/kardio202215051477

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To determine the optimal surgical treatment of post-infarction left ventricular aneurysms.

MATERIAL AND METHODS

Our study included 83 patients who underwent surgery for left ventricular aneurysms between 2016 and 2019. We compared the effectiveness of two techniques: left ventricular linear repair by Cooley (group 1, 56 (67.5%) patients) and Dor procedure (group 2, 27 (32.5%) patients). All surgeries were performed under cardiopulmonary bypass and combined with myocardial revascularization. In preoperative period, 27 (32.5%) patients required levosimendan infusion due to congestive heart failure. Mean age of patients was 58.7±7.1 years.

RESULTS

Mean ICU-stay was 2.6±1.3 and 3.4±1.6 days, respectively. Five patients required intra-aortic balloon counterpulsation in post-perfusion period due to low cardiac output (2 (3.5%) patients in the first group and 3 (11.1%) patients in the second group). Mean number of coronary grafts was 2.1±0.5 and 1.6±0.6, respectively. In early postoperative period, LV dimensions significantly decreased in the 2nd group.

CONCLUSION

Both methods significantly increased LV ejection fraction, but survival was similar in both groups.

Keywords:

LV aneurysm

myocardial infarction

linear LV repair

Dor procedure

coronary artery bypass grafting

Authors:

Plechev V.V.

Republican Cardiology Center

Yunusov V.M.

Republican Cardiology Center

Sagatdinov T.Sh.

Republican Cardiology Center

Prudko E.L.

Republican Cardiology Center

Abbazov I.U.

Republican Cardiology Center

Received:

07.07.2021

Accepted:

07.10.2021

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References:

Belov YuV, Varaksin VA. Post-infarction left ventricular remodeling: from concept to surgical treatment. M.: DeNovo; 2002:194. (In Russ.).
Chernyavsky AM, Khapaev SA, Marchenko AV, et al. Long-term results of left ventricular reconstruction for post-infarction aneurysms. Thoracic and Cardiovascular Surgery. 2006;4:4-8. (In Russ.).
Applebaum E, Nicolson GHB. Occlusive diseases of the coronary arteries: An analysis of the pathological anatomy in 168 cases with electrocardiographic correlation in 36 of these. Am Heart Journal. 1935;10(5):662-680. https://doi.org/10.1016/S0002-8703(35)90259-9
Schlicter J, Hellerstein HK, Katz LN. Aneurysm of the heart: A correlative study of one hundred and two proved cases. Medicine (Baltimore). 1954;33:43-86.
Cheng TO. Incidence of’ ventricular- aneurysm in coronary artery disease: An angiographic appraisal. Am J Med. 1971;50:340-355. https://doi.org/10.1016/0002-9343(71)90223-3
Galeati DG. De bononiensi scientiarum et artium instituto atque academia commentarii. De Morbis Duobus. 1757;IV:26.
Tennant R, Wiggers CJ. Effect of coronary occlusion on myocardial contraction. Amer J Physiol. 1935;112(2):351-361. https://doi.org/10.1152/ajplegacy.1935.112.2.351
Murray C. Pathophysiology of the cause of death from coronary thrombosis. Ann Surg. 1947;126(4):523-534. https://doi.org/10.1097/00000658-194710000-00012
Dubnow NH, Burchell HB, Titus JL. Post infarction ventricular aneurysm: A cliniconmorphologic and electrocardiographic study of 80 cases. Am Heart J. 1965;70:753-760. https://doi.org/10.1016/0002-8703(65)90331-5
Abrams DL, Edelist A, Luria MH, Miller AJ. Ventricular aneurysm: A reappraisal based on a study of sixty-five consecutive autopsied cases. Circulation. 1963;27:164-169. https://doi.org/10.1161/01.cir.27.2.164
Cabin HS, Roberts WC. Left ventricular aneurysm, intraaneurysmal thrombus, and systemic embolus in coronary heart disease. Chest. 1980;77(5):586-590.
Bjork VO. Ventricular aneurysm. Thorax. 1964;19:162-165.
Kirklin JW, Barratt-Boyes BG. Cardiac surgery. 2nd edition. New York: Churchill-Livingstone; 1993:204-205.
Kivikko M, Lehtonen L, Colucci W. Sustained Hemodynamic Effects of Intravenous Levosimendan. Circulation. 2003;107:81-86. https://doi.org/10.1161/01.cir.0000043245.00859.11
Ukkonen H, Saraste M, Akkila J, et al. Myocardial efficiency during levosimendan infusion in congestive heart failure. Clinical Pharmacology & Therapeutics. 2000;68:522-531. https://doi.org/10.1067/mcp.2000.110972
Jatene AD. Left ventricular aneurysmectomy. Resection or reconstruction. J Thorac Cardiovasc Surg. 1985;89:321-331.
Dor V, Saab M, Coste P, Kornaszewska M, Montiglio F. Left ventricular aneurysm: A new surgical approach. Thorac Cardiovasc Surg. 1989;37:11-19. https://doi.org/10.1055/s-2007-1013899
Lundblad R, Abdelnoor M, Svennevig JL. Surgery for left ventricular aneurysm: early and late survival after simple linear repair and endoventricular patch plasty. J Thorac Cardiovasc Surg. 2004;128:449-456. https://doi.org/10.1016/j.jtcvs.2004.04.017
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;46:29-35. https://doi.org/10.1016/s0003-4975(10)65847-x
Coskun KO, Popov AF, Coskun ST, et al. Surgical treatment of left ventricular aneurysm. Asian Cardiovasc Thorac Ann. 2009;17:490-493. https://doi.org/10.1177/0218492309348636
Isomura T, Horii T, Suma H, et al. Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: treat form not disease. Eur J Cardiothorac Surg. 2006;29(Suppl 1): 245-250. https://doi.org/10.1016/j.ejcts.2006.03.008
Chen WY, Wu FY, Shih CC, et al. Left ventricular aneurysm repair: A comparison of linear versus patch remodeling. J Chin Med Assoc. 2009;72:414-421.
Yan J, Jiang S-L. Impact of surgical ventricular restoration on early and long-term outcomes of patients with left ventricular aneurysm. A single-center experience. Medicine. 2018;97(41):e12773. https://doi.org/10.1097/MD.0000000000012773
Chernyavsky AM, Ruzmatov TM, Efendiev VU. Ischemic mitral insufficiency and survival after left ventricular reconstruction and isolated coronary bypass grafting in patients with severe left ventricular systolic dysfunction (6-year follow-up). Heart Failure. 2013;14(6):347-352. (In Russ.).