Principles of surgical treatment of post-infarction left ventricular aneurysms

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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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