Surgical treatment of post-infarction left ventricular pseudoaneurysm: A two-decade experience


Eren E., BOZBUĞA N., Toker M. E., Keles C., Rabus M. B., Yildirim O., ...Daha Fazla

Texas Heart Institute Journal, cilt.34, sa.1, ss.47-51, 2007 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 1
  • Basım Tarihi: 2007
  • Dergi Adı: Texas Heart Institute Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.47-51
  • Anahtar Kelimeler: Aneurysm, false/surgery, Coronary artery bypass, Heart rupture, post-infarction/therapy, Heart ventricles, Myocardial infarction/complications, Retrospective studies, Ventricular dysfunction, left
  • İstanbul Üniversitesi Adresli: Evet

Özet

Herein, we present a retrospective analysis of our experience with acquired pseudoaneurysms of the left ventricle over a 20-year period. From February 1985 through September 2004, 14 patients underwent operation for left ventricular pseudoaneurysm in our clinic. All pseudoaneurysms (12 chronic, 2 acute) were caused by myocardial infarction. The mean interval between myocardial infarction and diagnosis of pseudoaneurysm was 7 months (range, 1-11 mo). The pseudoaneurysm was located in the inferior or posterolateral wall in 11 of 14 patients (78.6%). In all patients, the pseudoaneurysm was resected and the ventricular wall defect was closed with direct suture (6 patients) or a patch (8 patients). Most patients had 3-vessel coronary artery disease. Coronary artery bypass grafting was performed in all patients. Five patients died (postoperative mortality rate, 35.7%) after repair of a pseudoaneurysm (post-infarction, 2 patients; chronic, 3 patients). Two patients died during follow-up (median, 42 mo), due to cancer in 1 patient and sudden death in the other. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients. Surgical repair is warranted particularly in cases of large or expanding pseudoaneurysms because of the propensity for fatal rupture. © 2007 by the Texas Heart® Institute.