Long term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta coronary bypass

J. M. Aranda, B. Befeler, Richard J Thurer, A. Vargas, N. El-Sherif, R. Lazzara

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Late clinical and hemodynamic evaluations in 18 patients with ventricular aneurysmectomy and aorta-coronary bypass are presented. Ten patients had significant obstructive lesions in two major vessels (55 per cent), and 6 had extensive three vessel disease (33 per cent). In 13 patients, 21 aorta-coronary saphenous bypass grafts were performed in addition to aneurysmectomy. The operative mortality rate was 11 per cent. One patient died suddenly 5 months after the operation (one year mortality rate 17 per cent). The 15 surviving patients have been followed up for 12 to 41 months (average 24 months). Clinical results were considered excellent in 2 patients who have been asymptomatic (Class I, N.Y.H.A.). Nine others were considered to have good clinical results (Class II). Five patients have continued to have congestive heart failure and angina on minimal effort (Class III or IV). Six of the 11 patients considered to have excellent or good results underwent postoperative hemodynamic studies 6 to 34 months after the operation. A significant increase in cardiac index was documented in all 6 patients. Paradoxic movement was not detected in any of the postoperative ventriculograms. Five of the seven venous grafts inserted were patent. Elevated left ventricular end-diastolic pressure (LVEDP), low cardiac index, and a persistent dyskinetic area in the left ventricle were found in 2 patients considered to have poor clinical results. Clinical and hemodynamic evaluations have shown a significant improvement in most patients surviving ventricular aneurysmectomy. However, postoperative systemic embolism, myocardial infarction, progression of coronary artery disease, transient cerebral ischemic attacks, graft occlusion, arrhythmias, and mitral regurgitation in previously prolapsed mitral valve leaflets account for progressive disability and limited activity after a successful operation.

Original languageEnglish
Pages (from-to)772-779
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume73
Issue number5
StatePublished - Dec 1 1977
Externally publishedYes

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Aorta
Hemodynamics
Transplants
Clinical Studies
Mitral Valve Prolapse
Mortality
Transient Ischemic Attack
Mitral Valve Insufficiency
Embolism
Heart Ventricles
Cardiac Arrhythmias
Coronary Artery Disease
Heart Failure
Myocardial Infarction
Blood Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Aranda, J. M., Befeler, B., Thurer, R. J., Vargas, A., El-Sherif, N., & Lazzara, R. (1977). Long term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta coronary bypass. Journal of Thoracic and Cardiovascular Surgery, 73(5), 772-779.

Long term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta coronary bypass. / Aranda, J. M.; Befeler, B.; Thurer, Richard J; Vargas, A.; El-Sherif, N.; Lazzara, R.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 73, No. 5, 01.12.1977, p. 772-779.

Research output: Contribution to journalArticle

Aranda, JM, Befeler, B, Thurer, RJ, Vargas, A, El-Sherif, N & Lazzara, R 1977, 'Long term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta coronary bypass', Journal of Thoracic and Cardiovascular Surgery, vol. 73, no. 5, pp. 772-779.
Aranda, J. M. ; Befeler, B. ; Thurer, Richard J ; Vargas, A. ; El-Sherif, N. ; Lazzara, R. / Long term clinical and hemodynamic studies after ventricular aneurysmectomy and aorta coronary bypass. In: Journal of Thoracic and Cardiovascular Surgery. 1977 ; Vol. 73, No. 5. pp. 772-779.
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