Early and late results of resection of ventricular aneurysm

Fifty-seven patients have undergone ventricular aneurysm resection with a mortality rate of 10 percent. Recent surgical trends have been toward complete revascularization and treatment of concomitant disorders when present. Although the early mortality rate may be favorably influenced by these maneuvers, analysis of survivors reveals no significant difference in survival between the group that had concomitant coronary artery bypass and the group that had aneurysm resection alone (84 percent versus 78 percent). There were significantly more asymptomatic patients in the revascularized group, however (74 percent versus 53 percent). Analysis of hospital deaths revealed nearly all to be secondary to low output syndrome, arrhythmia, myocardial infarction, or a combination of the three. Late death was due to either congestive heart failure or a myocardial infarction in all but one case. Seventy-seven percent of operative survivors are asymptomatic. Late morbidity is usually related to ungrafted or progressive coronary artery disease and generally has been successfully managed by reoperation.