Experience of post-infarction left ventricular aneurysm reconstruction with on-pump beating heart technique

Abstract


Aim. To evaluate the results of surgical treatment of post-infarction left ventricular aneurysms with on-pump beating heart technique.

Methods. In our center from April, 2009 to January, 2014 169 patients had reconstruction of the left ventricle with on-pump beating heart technique. Among the patients 159 were males (94.1%) and 10 of them were females (5.9%), average age 53.8±8.9 years (39 to 72 years). Angina pectoris class I (according to the classification of Canadian Heart Association) was established in 7 (4.1%) patients, class II - in 49 (29.0%), class III - in 107 (63.3%), class IV - in 4 (2.4%), unstable angina in 2 (1.2%) patients. Chronic heart failure class I (according to New York Heart association functional classification) was diagnosed in 5 (3.0%) patients, class II in 37 (21.9%), class III in 124 (73.4%), class IV in 3 (1.8%) patients. Average ejection fraction of the left ventricle was 38.6±7.9% (25 to 67%). Mitral valve insufficiency stage 2-3 was revealed in 23 (13.6%) patients.

Results. Endoventriculoplasty of the left ventricle by Dor's technique was performed in 49 (29.0%) patients, auto-septoplasty of the left ventricle - 59 (34.9%) patients, linear repair in 40 (23.7%) patients. Combined surgical interventions were performed in 21 (12.4%) patients. In-hospital lethality was 2.4% (n=4).

Conclusion. Left ventricular reconstruction with on-pump beating heart technique without cardioplegic arest is effective and safe; the method allows performing remodelling of the left ventricle and reaching the target volume parameters.


D G Tarasov

Federal Centre for Cardiovascular Surgery

Email: docpavlov1976@gmail.com
Astrakhan, Russia

I I Chernov

Federal Centre for Cardiovascular Surgery

Email: docpavlov1976@gmail.com
Astrakhan, Russia

A V Molochkov

Central Clinical Hospital of the Presidential Administration of the Russian Federation

Email: docpavlov1976@gmail.com
Moscow, Russia

A V Pavlov

Federal Centre for Cardiovascular Surgery

Author for correspondence.
Email: docpavlov1976@gmail.com
Astrakhan, Russia

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© 2019 Tarasov D.G., Chernov I.I., Molochkov A.V., Pavlov A.V.

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