OBJECTIVE

To assess the early and long-term postoperative outcomes in patients with Menicanti type III LV aneurysm and ejection fraction less than 30%.

MATERIAL AND METHODS

A single-center retrospective study included 272 patients with severely reduced LV ejection fraction (less than 30%) and LV aneurysm Menicanti type III. Patients were divided into 2 groups: the first group — LV reconstruction and coronary artery bypass grafting; the second group — mitral valve repair in addition to LV reconstruction and CABG.

RESULTS

In-hospital mortality was 10% (n=7) and 2.5% (n=5), respectively. The follow-up period was 150 months. In long-term period, 55 patients died from progression of heart failure (19 and 36 patients, respectively). In long-term period, recurrence of moderate-to-severe mitral regurgitation occurred in 16 and 24 patients, respectively. Multiple regression analysis was performed to identify predictors of lethal outcomes. No mitral valve repair and SyntaxScore were predictors of mortality.

CONCLUSION

Mortality was higher after left ventricular reconstruction without mitral valve repair. Mortality was higher by 6.9 times in patients without mitral valve repair (OR=6.9; p=0.035), and increased by 11% with decrease of SyntaxScore by 1 point (OR=0.89; p=0.045).