Acessibilidade / Reportar erro

Surgical correction of left ventricular aneurysm: comparison between linear suture and geometric reconstruction techniques

OBJECTIVE: To evaluate the evolution up to 15 years of patients who underwent surgical correction of left ventricular aneurysm and to compare the techniques of linear suture and geometric reconstruction. METHODS: We studied 213 patients, of which 166 (77.9%) were men. The mean age was 53.1 years (SD=9.9 years). Of these, 145 (68%) underwent repair using the linear suture technique and 68 (32%) underwent the geometric reconstruction technique. The Kaplan - Meier method was used to evaluate late survival. We evaluated the presence of mural thrombus, in and out of hospital mortality and the possibility of myocardial revascularization in the same procedure. Statistical differences were measured using the Log Rank method for actuarial curves and the nonparametric test in the remaining data compared. RESULTS: Our survival curves after a follow up of 10 years demonstrated that patients submitted to the linear suture and LV geometric reconstruction had a survival of 47.19% (SEM=0.056) and 63,55% (SEM=0.068), respectively, which were not statistically significantly different (p= 0.56). The overall survival in the 2 groups together was 51.34% (SEM=0.0473) at 10 years and 35,77%(SEM=0.0684) at 15 years. The in hospital death was 9.5% for the linear suture and 16.6% for the geometric reconstruction (p=0.17). The removal of LV thrombus was 31.29% and 45.45%, respectively (p=0.07). Revascularization was performed in, 69% of the patients in the linear suture group and 85.3% in the geometric reconstruction group. Comparing patients who were revascularized with those who were not, there was a better survival at 10 years for the first group (p=0.008). CONCLUSIONS: There was no statistically significant difference in the survival of patients who underwent linear suture compared to geometric reconstruction of the LV for aneurysm repair. Our results demonstrated superior survival in those patients who could undergo revascularization in the same procedure.

Heart ventricle; Heart aneurysms; Heart ventricle aneurysm; Heart ventricle aneurysm; Heart ventricle aneurysm; Heart ventricle aneurysm; Surgical anastomoses


Sociedade Brasileira de Cirurgia Cardiovascular Rua Afonso Celso, 1178 Vila Mariana, CEP: 04119-061 - São Paulo/SP Brazil, Tel +55 (11) 3849-0341, Tel +55 (11) 5096-0079 - São Paulo - SP - Brazil
E-mail: bjcvs@sbccv.org.br