Clinical profile and outcome of patients with chronic postinfarction left ventricular false aneurysm treated surgically.

Abstract

BACKGROUND:

Rupture of the left ventricular (LV) free wall is usually fatal. In rare instances, hemorrhage is confined, and a false aneurysm (pseudoaneurysm) forms. In this study we reviewed our experience with patients treated surgically for chronic LV pseudoaneurysm.

METHODS:

Between 1997 and 2001, pseudoaneurysm was diagnosed in 8 patients (6 men and 2 women) 55.9+/-7.6 years of age, and the patients underwent surgery. Before operation electrocardiogram (ECG), chest x-ray, echocardiography, and cardiac catheterization were performed. Repair was accomplished by resection of the pseudoaneurysm with use of cardiopulmonary bypass and in moderate systemic hypothermia (26 degrees C-28 degrees C). In 3 cases coronary artery bypass grafts were implanted, and in another a postinfarction ventricular septal rupture was closed.

RESULTS:

Before operation, 4 (50.0%) of the patients had congestive heart failure, 2 patients had unstable angina, and 2 were relatively asymptomatic. Six patients had ECG abnormalities (signs of myocardial infarction, persistent ST elevation). On chest x-ray 5 patients had cardiomegaly, and 2 of them had pulmonary edema. The definite diagnosis was established before operation in 7 patients and during the procedure in 1 patient. All patients survived operation, and none needed reoperation. An intraaortic balloon pump was used in 1 case. The postoperative courses of the other patients were uncomplicated. At the end of follow-up (mean, 31.0 +/- 12.4 months) all patients were alive in New York Heart Association functional class I (6 patients) or II (2 patients).

CONCLUSION:

The clinical presentation of chronic pseudoaneurysm often is nonspecific. The results of surgical treatment of chronic LV pseudoaneurysm are satisfactory.

• Authors: Bartlomiej Perek, Marek Jemielity, Wojciech Dyszkiewicz
• Journal: The heart surgery forum (Heart Surg Forum) Vol. 7 Issue 2 Pg. E132-5 (Apr 01 2004) ISSN: 1522-6662 [Electronic] United States
• PMID: 15138090 (Publication Type: Clinical Trial, Journal Article)

Topics

• Aged
• Aneurysm, False (etiology, surgery)
• Chronic Disease
• Female
• Humans
• Male
• Myocardial Infarction (complications, surgery)
• Outcome Assessment, Health Care
• Treatment Outcome
• Ventricular Dysfunction, Left (etiology, surgery)