[Aneurysmectomy and aortocoronary bypass. Immediate and long-term results of 56 patients].

56 pts. who underwent left ventricular aneurismectomy were studied. Clinical improvement and lat post-operatory mortality rate have been evaluated. 39 pts. (II group) also had aortocoronary bypass and other surgical procedures performed at the time of the aneurismectomy. Group I (no other surgery beside the aneurismectomy) and group II did not significant differences in the pre-operatory period and were, therefore, comparable. The total operatory mortality has been of 14% (17.6% in group I and 12.8% in group II). By using myocardial protection the mortality dropped to 5.8%. A significant difference between deceased and survived pts. was noted in the following parameters: cardiac index, A-V oxygen difference, extracorporeal circulation time and the number of diseased coronary arteries (P < 0.001-0.005). Only 2 pts., both in group II, had a late death. After the operation 32 pts. became asymptomatic. Five pts. remained symptomatic: 3 continued to complain of angina and 2 to show signs of left ventricular failure; ventricular arrhythmias were still present in 6 pts. post-operatively (compared to 16 pts. pre-op.). The data suggested that aneurismectomy, associated with aorto-coronary bypass and myocardial protection, has an acceptable operatory risk, particulary in pts. with a good residual ventricular function. Except for ventricular arrhythmias clinical results are very good and late mortality rate is low