ENDOANEURYSMORRHAPHY FOR LEFT-VENTRICULAR ANEURYSM - FOLLOW-UP IN 69 PATIENTS

We reviewed the cases of 69 consecutive patients who underwent physiol ogic reconstruction of the left ventricular cavity with an endoventric ular patch (endoaneurysmorrhaphy) after aneurysmectomy. Eight patients had isolated endoaneurysmorrhaphy, 60 patients had concomitant corona ry artery bypass grafting and ? patient had concomitant closure of an atrial septal defect. The primary indications for operation were angin a pectoris (New York Heart Association functional class I or II) in 42 patients and dyspnea (functional class III or IV) in 27 patients. The preoperative left ventricular ejection fraction evaluated with ventri culography was 28.95% +/- 7.27% (mean +/- standard error of the mean). The global perioperative mortality rate was 2.8%. Total follow-up was 139.3 patient-years. The late mortality rate was 4.3% per patient-yea r. A marked increase was found in the mean postoperative left ventricu lar ejection fraction of the patients: 41.91% +/- 11.83%. Survivors we re interviewed in person; their functional status was class I or II in 58 patients and class III in 3 patients. We conclude that left ventri cular endoaneurysmorrhaphy results in satisfactory functional improvem ent and can be performed with relatively low early and late mortality rates.