Endoventricular pericardial patch plasty in the management of left ventricular aneurysms

Abstract

Early and late surgical outcomes of endocardial resection and aneursymectomy repaired with autologous pericardial patch were studied. Methods: We retrospectively studied 105 patients who underwent endoaneurysmorrhaphy with pericardial patch during the period from June 1993 until June 1999. 104 patients had associated coronary artery lesions and 1 had concomitant mitral valve stenosis. Preoperative, early postoperative results of all patients and late clinical outcome of 102 patients, echocardiography of 45 and hemodynamic controls of 1 2 patients within a mean {follow-up of 42$pm$8 months were analyzed. Results: Mean New York Heart Association Class (NYHA) improved to postoperative 1.2$pm$0.5 (from preoperative 2.7$pm$0.4. Mean number bypass grafts was 2.6$pm$1.1. Left ventricular ejection fraction rate improved to 46.8+8% in the early and 50.2$pm$9% in the late (follow-up compared with the preoperative 38.2$pm$9% (p' 0.05). Mean pulmonary artery pressure decreased to 16.3+3.2 mmHR from 22. h2.3 mmHg (p 0.05) in the early postoperative period. End-diastolic left ventricular pressure decreased to 1l.6$pm$2 mmHg (from the preoperative 20.2$pm$4.8 mmHR (p 0.05) and performance score to 9.2$pm$2 from the preoperative 14.1$pm$2 (p 0.01). Hospital mortality was 2.8% (3 patients) and no deaths were ohserved in the late follow-up. Conclusion: Endooaneurysmorrhaphy with pericardial patch may he an appropriate option in the management of left ventricular aneurysms with acceptable surgical results.