SURGICAL-CORRECTION OF THE LEFT-VENTRICUL AR GEOMETRY IN POSTINFARCTION ANTEROAPICAL LEFT-VENTRICULAR ANEURYSMS

Left ventricular aneurysm (LVA) following myocardial infarction carry a high morbidity and mortality, which may be reduced by appropriate su rgical treatment. The Jatene correction is an attractive technique for aneurysm repair. We have employed a modified Jatene correction in 72 patients between July 1986 and May 1995. There were 57 men and 15 wome n, mean age 61.6 +/- 8.2 years old. Fifteen patients (21 %) presented with malignant recurrent Ventricular arrhythmias. Fourteen patients ha d emergency operations and 3 were redo coronary artery bypass grafts. Fifty-eight patients (83 %) were in NYHA class III and IV. Fifty-two p atients had 3-vessel disease. Preoperative left Ventricular ejection f raction (LVEF) was 30.4 +/- 12.2 % (10-59 %) and left ventricular end- diastolic pressure was 26.2 +/- 10.1 mmHg (12-41 mmHg). The overall pe rioperative mortality was 11.1 %. one patient had a peroperative myoca rdial infarction. Immediately postoperatively, 17 patients had low car diac output, requiring intraaortic balloon pump in eight cases. There were no bleeding problems and 30 patients (42 %) had no postoperative complications whatsoever. The average hospital stay was 10.2 days. Lef t ventricular cavity size, measured (echocardiography) showed signific ant reduction 1 week postoperatively, which was unchanged after 1 mont h. The left ventricular ejection fraction was significantly increased 1 month postoperatively. After follow-up, on average 20 months, there was significant improvement in mean NYHA class. The modified Jatene co rrection of left ventricular aneurysm is simple, carries acceptable mo rtality and low morbidity and significantly improves left ventricular function.