COMPARATIVE METHODS OF REPAIRING LEFT-VENTRICULAR ANEURYSMS

Between ir March 1992 and 31 June 1996, we enrolled 72 patients with l eft ventricular aneurysms in a ?prospective, nonrandomized study to co mpare-by study of cardiac indices, single-plane ejection fractions, an d nuclear ventriculograms-the effects of classical aneurysmectomy (gro up I, n=36) with those of endoaneurysmorrhaphy (group 2, n=36). Preope rative and postoperative cardiac index measurements were, respectively , 1.96 +/- 0.6 and 3.51 +/- 0.53 for group I, and 1.96 +/- 0.31 and 3. 43 +/- 0.41 for group 2. in this regard, there was not any significant difference between the groups preoperatively or postoperatively. Preo perative and postoperative multiple-gated acquisition measurements wer e, respectively, 34.3 +/- 7.76 and 43.1 +/- 11.1 for group I, and 37 /- 3.88 and 66.5 +/- 5.2 for group 2. Although there was not any signi ficant preoperative difference between the groups (P=0.34), group 2 ha d significant postoperative improvement in left ventricular ejection f ractions (P<0.001). Preoperative and postoperative single-plane contra st ventriculographic ejection fractions were, respectively, 43.4 +/- 8 .7 and 48.6 +/- 11.2 for group 1, and 43.8 +/- 5.5 and 60.8 +/- 15.1 f or group 2. Again, there was not any significant difference between th e 2 groups in preoperative left ventricular ejection fractions (P=0.87 ), but the postoperative left ventricular ejection fractions of group 2 were significantly better than those of group I (P=0.022). We conclu de that left ventricular functional improvement with endoaneurysmorrha phy is superior to that with classical aneurysmectomy.