Clinical, angiographic and hemodynamic parameters were assessed preoperativelyand 12–20 weeks (mean ± SD: 14 ± 2) after left ventricular anterior aneurysmectomy in 31 consecutive patients. In 18 patients, associated coronary artery bypass surgery was necessary (1.4 grafts/patient). One patient with mitral valve insufficiency postoperatively required mitral valve replacement. No other complications and no deaths arose. The working capacity of the patients, as measured by bicycle exercise testing, compared a stage of exercise that the patient reached to the expected level of exercise for a normal person of the same sex, age and body surface. Expressed as percent of normals it increased from 39.3 ± 28.9% (mean ± SD) to 60.8 ± 15.5% (p < 0.001), angina-pectoris-free working capacity increased from 52.6 ± 41.4 to 89.2 ± 33.2 W (p < 0.001). Left ventricular end-diastolic volume was determined by simultaneous biplane angiography and decreased from 277.1 ± 84.7 to 191.0 ± 49.1 ml (p < 0.001). Ejection fraction increased from 35.4 ± 12.4 to 41.0 ± 9.6% (p < 0.05). Left ventricular end-diastolic pressure after angiography decreased from 24.6 ± 9.2 to 21.1 ± 11.3 mm Hg (p < 0.05). We found concomitant reduction of the left ventricular (minute) mean working index from 3.7 ± 1.2 to 3.1 ± 0.9 kg·m/min/m2 (p < 0.01), evidence of changed pressure-volume relationship and reduced cardiac work indicative of successful aneurysm repair.

Keywords:
Left ventricular (minute) mean working index, Aneurysmectomy, Left ventricular volume
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© 1988 S. Karger AG, Basel
1988
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