HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Akins, C. W. Search for Related Content PubMed PubMed Citation Articles by Akins, C. W.

The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 610-618, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Resection of left ventricular aneurysm during hypothermic fibrillatory arrest without aortic occlusion

CW Akins

From December, 1977, through September, 1984, 100 consecutive patients had ventricular aneurysmectomy during hypothermic fibrillatory arrest without aortic occlusion. In the series were 83 men and 17 women, mean age 57.2 years. Primary indications for operation were angina pectoris in 42 patients, congestive heart failure in 23, angina plus congestive failure in 22, and refractory ventricular irritability in 13. Emergency operation was required for 13 patients with an intra-aortic balloon pump. Mean New York Heart Association Class was 3.1. Mean left ventricular end-diastolic pressure was 19.5 mm Hg, and mean left ventricular ejection fraction was 0.37. Concomitant coronary artery grafting was performed in 97 patients (mean 3.2 grafts/patient). Pressor agents were used in 21 patients and an intra-aortic balloon pump in two patients. Perioperative myocardial infarction was documented in one patient (1%). There were two hospital deaths (2%), both in patients with refractory ventricular irritability. At late follow-up (mean 38.5 months), 13 additional patients (13.3%) had died. Actuarial survival rate at 73 months was 77.0%. Survival rate was better for 93 patients with anterior aneurysms if the left anterior descending and/or diagonal coronary arteries were grafted with aneurysmectomy (p less than 0.03). Although only ventricular arrhythmias predicted early death (p less than 0.03), ejection fraction (p less than 0.01) and ventricular arrhythmias (p = 0.03) predicted late death. Ventricular aneurysmectomy during hypothermic fibrillatory arrest without aortic occlusion can be performed with low hospital mortality and good long-term results. When possible, left anterior descending and/or diagonal coronary arteries should be grafted when anterior aneurysms are resected.

This article has been cited by other articles:

				P. Klein, J. J. Bax, L. J. Shaw, H. H.H. Feringa, M. I.M. Versteegh, R. A.E. Dion, and R. J.M. Klautz Early and late outcome of left ventricular reconstruction surgery in ischemic heart disease Eur. J. Cardiothorac. Surg., December 1, 2008; 34(6): 1149 - 1157. [Abstract] [Full Text] [PDF]

				D. D. Glower and J. E. Lowe Left Ventricular Aneurysm Card. Surg. Adult, January 1, 2008; 3(2008): 803 - 822. [Full Text]

				D. D. Glower and J. E. Lowe Left Ventricular Aneurysm Card. Surg. Adult, January 1, 2003; 2(2003): 771 - 788. [Full Text]

				L. L. Mickleborough, H. Maruyama, P. Liu, and S. Mohamed Results of left ventricular aneurysmectomy with a tailored scar excision and primary closure technique J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 690 - 698. [Abstract] [Full Text]