TYPES OF SURGICAL TREATMENT FOR POSTINFARCTION LEFT VENTRICULAR ANEURYSMS

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Abstract

Surgical treatment of postinfarction left ventricular aneurysms in ischemic heart disease patients allows for a significant improvement of outcomes and clinical endpoints, an increase in quality of life and survival. The article deals with historical periods in surgical treatment of left ventricular aneurysms and chronologically describes the history of methods for reconstruction of the left ventricle.

Despite the fact that within the last 50 years, mainly due to improvements in surgical techniques, in-hospital mortality decreased two-fold, it still remains high. The choice of technique for any kind of ventricular reparation depends on localization of the lesion that defines which sites of left ventricular asynergia should be repaired and how its form should be restored. At present, it is not possible to reliably assess benefits of any type of reparative surgery over another. Risk factors of inhospital mortality are: age, incomplete myocardial revascularization, high grade heart failure, female gender, immediate surgery, ejection fraction below 30%. To improve clinical outcomes one should strive to approximate to the physiological form of the left ventricle, to minimize negative influence of surgery on myocardial contractility.

About the authors

A. V. Pavlov

Astrakhan State University; Federal Center for Cardiovascular Surgery

Email: fake@neicon.ru

Assistant Professor, Chair for Cardiovascular Surgery, Postgraduate Training Faculty; Cardiac Surgeon in the Department of Cardiosurgery

Russian Federation

M. L. Gordeev

Federal North-West Medical Research Centre

Email: fake@neicon.ru

MD, PhD, Professor, Head of Department of Cardiothoracic Surgery

Russian Federation

V. I. Tereshchenko

Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies

Author for correspondence.
Email: heart-rus@yandex.ru

PhD, Cardiac Surgeon in the Department of Surgical Treatment of Heart Disease

Russian Federation

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Copyright (c) 2015 Pavlov A.V., Gordeev M.L., Tereshchenko V.I.

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