ABSTRACT
INTRODUCTION: Left ventricular aneurysms are serious long-term complications from acute myocardial infarction that produce hemodynamic alterations in the cardiac function. OBJECTIVE: The aim of this study is to evaluate the chirurgical and clinic results of the endoventricular patch repair of the akinetic or dyskinetic portions of the left ventricle. METHODS: From August 2002 to October 2005, 20 consecutive patients underwent surgical repair of left ventricular aneurysm using the endoventricular patch repair technique. The mean age was 63,6 years, and 80% where male. Every patient have had only one episode of acute myocardial infarction, which resulted in a akinetic or dyskinetic alteration in the motility of the left ventricle. The preoperative functional class of most of the patients was class III or IV and 45% where on angina class II. In 90% of the patients the ventricular aneurysm where antero-septal. Left ventricular dysfunction was present in 65%. RESULTS: All patients underwent the Dor procedure associated with coronary artery bypass grafting. There was no perioperative mortality. One patient died in the immediate postoperative period. Four patients needed inotropic support for more than 24h and intra-aortic balloon pumping was used postoperatively in two cases. Mean hospital stay was 8,6 days. At late follow-up the functional class was I in 20%, class II in 55% and class III in 10%. The angina class was I in 65% of the cases. CONCLUSIONS: The surgical repair of left ventricular aneurysm using the endoventricular patch repair technique proved to be safe, causing significant clinical improvement and an increase in the ejection fraction.
