Left ventricular dimension and shape after postinfarction aneurysm repair

Objective: We evaluated left ventricular dimensions and shape in the patients with postinfarction LV aneurysm before and after different techniques of ventricular reconstruction. Methods: From January 1997 to December 2003, 158 patients underwent LV aneurysm repair. There were 152 men and 6 women, with a mean age 50 +/- 8.4 years. Ventricular reconstruction was performed by using linear plasty of the Cooley technique in 35 patients, septal plasty of the Stoney technique-in 57 patients, and endoventriculoplasty of the Dor technique-in 66 patients. Left ventricular volumes and dimensions, global and contractile left ventricular function, diastolic sphericity were analyzed before and after operation over a period of 10 days to 5 years. Results: The EchoCG studies showed a significant postoperative improvement of the LV contracting function regardless of LV plasty technique used. The index of sphericity changed from 0.71 +/- 0.08 to 0.72 +/- 0.06 after linear plasty, from 0.71 +/- 0.05 to 0.73 +/- 0.07 after septal plasty, from 0.74 +/- 0.06 to 0.56 +/- 0.05 after endoventriculoplasty. The hospital mortality rate was 6.3%. There is no significant difference in hospital mortality rates between the different techniques of LV aneurysm repair. Conclusions: Our results show the effectiveness of different techniques of LV aneurysm repair, when the differentional approach to choice an adequate method of ventricular reconstruction was applied. (c) 2005 Elsevier B.V. All rights reserved.