Left ventricular aneurysm. The Wessex experience.

One hundred patients with left ventricular aneurysms were operated on between February 1973 and January 1983. The principal indications for operation were left ventricular failure in 58, angina in 23, both in 17, with arrhythmia and systemic emboli accounting for one case each. Eighty five had had anterior infarction causing 82 anteroapical and three lateral aneurysms, while the remainder had had inferior infarcts resulting in 14 inferior aneurysms and one lateral aneurysm. Coronary angiography detected a single coronary lesion in 46%. Three patients had aneurysmal plication and the remainder had aneurysmectomy. Eleven mitral valve replacements were performed. Forty patients underwent coronary artery bypass grafting with a mean number of grafts per patients of 1.4. The early mortality was 7% with no early deaths since 1978. The actuarial five year survival was 68%, and 82% of survivors are in New York Heart Association class I or II (mean follow up three years). Left ventricular aneurysmectomy may be performed with a low operative mortality and good long term results.