Evaluation of the left ventricular performance and dimensions in patients underwent left ventricular endoaneurysmorrhaphy for left ventricular aneurysm

ABSTRACT

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