Subject(s)
Humans , Male , Female , Ventricular Function, Left , Epidemiology , Outcome Assessment, Health CareABSTRACT
From March 1989 till September1991. one hundred consecutive patients with post infarction left ventricular aneurysm underwent left ventricular endoaneurysmorrhaphy at Texas Heart Institute, using a reparative techniques for left ventricular aneurysm described by Dr. Cooley in 1989, in which a fabric patch is used in the repair of left ventricular aneurysm. Ninety patients [96%] in addition to endoaneurysmorrhaphy had associated cardiac procedures. The clinical evaluation was done by using two dimensional endoaneurysmorrhaphy both in the pre-operative period [24 to 48 hours before surgery] and 3 weeks following surgery to study left Ventricular Ejection Fraction [LVEF], left Ventricular end diastolic diameter [LVEDD] and left Ventricular End Systolic Diameter [LVESD]. The mean pre-operative LVEF was 31.3 +/- 9.9% compared to 38.30 +/- 11.5[P < 0.001] in the post-operative period. The mean pre-operative LVEDD was 6.4 +/- 0.5 cms which reduced to post-operative period. The mean pre-operative LVEDD was 6.4 +/- 0.5 cms which reduced to post-operative values of 5.5 +/- 0.71cms [P < 0.001], and the mean pre-operative LVESD was 5.5 +/- 0.78 cms reduced to post-operative values of 3.97 +/- 0.609 cms [P < 0.001]. There was a marked symptomatic improvement in NYHA functional class in patient who survived the procedure. The mortality in this series was 9 patients [9%]. This showed significant functional improvement for patients who underwent left ventricular endoaneurysmorrhaphy with statistically significant improvement in LVEF and reduction of the LVEDD and LVESD