FUNCTIONAL RESULTS OF LEFT-VENTRICULAR RECONSTRUCTION

From 1988 to 1991, 48 patients with left ventricular aneurysm underwen t endoventriculoplasty with a circular patch to preserve the left vent ricular geometry. Of these patients, 98% underwent concomitant myocard ial revascularization, and in 77% the left anterior descending coronar y artery was bypassed. The overall operative mortality rate was 4.1%. The 3-year survival rate was 91%, and 67% of patients had no further c ardiac complications. Cardiac performance was assessed postoperatively by ventriculography in 28 patients. The global ejection fraction rose from 0.39 +/- 0.11 to 0.57 +/- 0.14 (p < 0.001); the left ventricular end-diastolic pressure fell from 20 +/- 7.5 mm Hg to 15 +/- 7.8 mm Hg (p < 0.05). Computerized analysis of regional contraction revealed a significant improvement in the anterolateral and apical segments and i n the transitional zone. In 61% of the patients, a normal contraction pattern resumed, whereas in the remaining 39%, a residual deformity of the left ventricular chamber was present. The best results were obtai ned in patients with a preserved proximal septum at echocardiography.