Surgical ventricular restoration versus isolated coronary artery bypass grafting for left ventricular aneurysm: comparison of mid- to long-term outcomes.
- Author:
Lei-Lei SHEN
1
;
Cheng WANG
;
Rong WANG
;
Cang-Song XIAO
;
Yang WU
;
Yao WANG
;
Zhi-Yun GONG
;
Peng-Fei GUO
;
Hai-Zhi ZHAO
;
Chang-Qing GAO
Author Information
- Publication Type:Journal Article
- MeSH: Aneurysm; surgery; Coronary Artery Bypass; Echocardiography; Heart Ventricles; surgery; Humans; Incidence; Retrospective Studies; Risk Factors; Stroke Volume; Survival Rate; Treatment Outcome; Ventricular Function, Left
- From: Journal of Southern Medical University 2016;36(5):681-687
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo compare the mid- to long-term outcomes of patients receiving isolated coronary artery bypass grafting (CABG) versus surgical ventricular restoration (SVR) plus CABG for left ventricular aneurysms.
METHODSThe clinical data were retrospectively analyzed in 205 patients with left ventricular aneurysms admitted to our hospital between January, 1997 and December, 2012, including 115 patients receiving SVR plus CABG and 90 undergoing isolated CABG. By matching preoperative echocardiographic parameters including aneurysm size, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and EuroSCORE risk factors, 32 patients receiving SVR plus CABG and another 32 with isolated CABG were enrolled in this study. The patients were compared for survival rates, major adverse cardiac or cerebrovascular events (MACCEs), left ventricular geometry and function at 1, 3 and 5 years of follow-up.
RESULTSCompared with the patients receiving isolated CABG, those receiving SVR and CABG showed greater improvements in echocardiographic parameters and NYHA functional class. The differences in the echocardiographic parameters between the two groups gradually reduced with time and became comparable at 5 years after the operation (P>0.05). No significant difference was found in the mid- to long-term survival or the incidence of MACCEs between the two groups (P>0.05).
CONCLUSIONCompared with isolated CABG, SVR plus CABG does not reduce the incidence of MACCEs or improve the mid- to long-term survival rate of patients with left ventricular aneurysm with a LVESVI <60 mL/m(2).