SYSTOLIC AND DIASTOLIC FUNCTION AFTER PATCH RECONSTRUCTION OF LEFT-VENTRICULAR ANEURYSMS

Left ventricular function after patch reconstruction for postinfarctio n left ventricular aneurysms is largely unknown. In this study, 16 pat ients with an anteroseptal-lateral left ventricular aneurysm were trea ted by reconstruction of the left ventricle using a Dacron patch. Coro nary artery bypass grafting was performed concomitantly in 9 patients. The size of the patch used was 57% +/- 19% of the resected myocardial scar area, including the sewing cuff area to be sutured. In these pat ients, the ejection fraction increased significantly from 0.28 +/- 0.1 2 to 0.39 +/- 0.12 (p = 0.007) at rest and from 0.32 +/- 0.14 to 0.41 +/- 0.10 (p = 0.008) during exercise. The left ventricular end-diastol ic pressure and left ventricular end-diastolic volume index were reduc ed significantly from 14 +/- 7.0 to 8 +/- 3.2 mm Hg (p = 0.032), and f rom 178 a 116 to 92 +/- 21 mL/m(2) (p = 0.016). The peak filling rate was improved significantly from 1.2 +/- 0.47 to 1.8 +/- 0.6/s (p = 0.0 48) postoperatively. The ratio of the peak now velocity during the atr ial kick phase to the peak flow velocity in the rapid filling phase, a t the level of the mitral valve, improved (p = 0.016) after operation and remained improved up to 16 to 24 months after operation. Patch rec onstruction of the left ventricle resulted in the recovery of systolic and diastolic function soon after operation, which has persisted into the late postoperative period.