Surgical treatment of post infarction left ventricular aneurysms.

The results of surgical treatment of post-infarction left ventricular aneurysms (PILVA) in 121 patients are analyzed. 64 patients underwent resection of the aneurysm, in 57 the resection was combined with aortocoronary shunt. Hospital mortality amounted to 11.6%. Analysis of mortality in relation to the initial values of the clinical, haemodynamic and contractility indicators has shown that the results of surgical treatment depend on the contractile function of the viable part of the left ventricle, on the blood flow in the left ventricular lateral wall and on the cardiac output. After surgery, signs of heart failure diminished or disappeared in 81% of the patients. The postoperative clinical course depended on the preoperative value of the ejection fraction of the contracting part of the left ventricle. Stenocardial pain disappeared or its frequency decreased in 91% of the patients. The patients' survival rate in the five-year postoperative period was 68%. The main factors of long-term prognosis were the degree of the coronary affection and the contraction capacity of the viable myocardium.