Department of Cardiovascular Surgery, Medical Faculty of Balikesir University, Balikesir, Turkey.
Department of Cardiovascular Surgery, Avrupa Safak Hospital, Gaziosmanpasa, Istanbul, Turkey.
Heart Surg Forum. 2020 Nov 2;23(6):E821-E825. doi: 10.1532/hsf.3251.
It is still controversial which left ventricular aneurysm repair technique is optimal in terms of early and late results. This study aimed to compare early postoperative outcomes for 2 surgical treatments of postinfarction left ventricular aneurysm: linear repair technique on arrested heart versus endoaneurysmorrhaphy repair with patch plasty on beating heart.
Prospectively collected data from 16 consecutive patients who underwent endoaneurysmorrhaphy repair with patch plasty on beating heart (the technique we have preferred since 2008) were compared with data from a retrospective series of 10 patients who underwent linear repair on arrested heart (the technique we preferred until 2008). All operations were performed under elective conditions.
Baseline characteristics of the 2 groups were similar. Complete revascularization for all diseased vessels was achieved in all patients. Durations of cross clamping, cardiopulmonary bypass, intensive care stay, and hospital stay were longer, and postoperative ejection fraction was lower, in the linear repair group compared with the endoaneurysmorrhaphy group (P < .05 for all). Early mortality occurred in 1 patient (3.8%) in the linear repair group.
Endoaneurysmorrhaphy repair with patch plasty on beating heart seems to offer advantages over the linear repair technique on arrested heart in the treatment of left ventricular aneurysms. Future large-scale prospective studies with longer follow-up are warranted to draw firm conclusions.
在手术治疗心肌梗死后左心室室壁瘤的早期和晚期结果方面，哪种左心室室壁瘤修复技术是最佳的仍存在争议。本研究旨在比较 2 种治疗心肌梗死后左心室室壁瘤的手术治疗方法的早期术后结果：停跳心脏下的线性修复技术与跳动心脏下的腔内修补术联合补片成形术。
前瞻性收集了 16 例接受跳动心脏下腔内修补术联合补片成形术（自 2008 年以来我们一直首选的技术）的患者的数据，并与 10 例接受停跳心脏下线性修复术（我们在 2008 年之前一直首选的技术）的患者的数据进行了比较。所有手术均在择期条件下进行。
两组的基线特征相似。所有患者均实现了所有病变血管的完全血运重建。与腔内修补术组相比，线性修复组的体外循环时间、心脏停跳时间、重症监护病房停留时间和住院时间更长，术后射血分数更低（所有 P 值均<0.05）。线性修复组有 1 例（3.8%）患者早期死亡。
与停跳心脏下的线性修复技术相比，跳动心脏下的腔内修补术联合补片成形术似乎在治疗左心室室壁瘤方面具有优势。需要进行未来的、规模更大的、随访时间更长的前瞻性研究，以得出明确的结论。
