The three dimensional (3D) conformational changes in three patients with la
rge anterior aneurysm in the left ventricle (LV) were examined before and t
wo years after aneurysmectomy by using 3D Cine-computerized tomography (CT)
.
Endocardial and epicardial tracings of 6-9 short axis images encompassing t
he entire LV were used to reconstruct the LV in 3D. Thickness and percent t
hickening were calculated using our 3D-volume element approach. A regional
wall stress index (stress/pressure) was calculated from regional curvature
and thickness.
The analysis showed that following resection of the aneurysm the end-diasto
lic volume was reduced from 257+/-39 to 183+/-39 ml, end-systolic volume fr
om 172+/-39 to 92+/-46 ml and, ejection fraction increased from 34+/-7 to 5
1+/-13%. The endocardial aneurysm area decreased from 19.7+/-15.9 to 10.1+/
-6.5 cm(2), whereas the normal zone area was minimally reduced from 87.4+/-
17.6 to 79.8+/-10.8 cm(2). The percent thickening of the normal zone increa
sed significantly. It is documented here for the first time by detailed 3D
analysis that the resection of the LV aneurysm reduces the aneurysmal area
and LV size and improves the global and regional function of the remote nor
mal zone. Therefore, the 3D approach can help to design better surgical tec
hnique for this complex operation. (C) 1999 IPEM. Published by Elsevier Sci
ence Ltd. All rights reserved.