SURGICAL-TREATMENT OF POSTINFARCTION FALSE ANEURYSM OF THE LEFT-VENTRICLE

Twelve patients underwent surgery for repair of false aneurysms of the left ventricle. ne mean interval between the myocardial infarction an d the diagnosis was 19 months (range 2 to 80 months). Congestive heart failure was the most common clinical presentation. Most patients had three-vessel coronary artery disease. The false aneurysm was posterior in 10 patients and anterior in two. Three patients with posterior ane urysm had severe mitral regurgitation. Repair was accomplished by rese ction of the false aneurysm and primary closure of the defect in four patients and by closure with a patch in eight. Nine patients also had coronary artery bypass. Mitral valve replacement was performed in thre e patients who had severe mitral regurgitation before the operation an d in one patient who had severe mitral regurgitation after repair of t he false aneurysm and could not be weaned from cardiopulmonary bypass. There were three operative deaths and one additional death after 2 mo nths. All deaths occurred in patients who had mitral valve replacement . Eight patients survived the operation and remained well after a mean follow-up period of 62 months. Patients with false aneurysms of the l eft ventricle do well after surgical repair, except when concomitant m itral valve replacement is necessary.