Late Clinical and Echocardiographic Follow-up After Left Ventricular Endoaneurysmorrhaphy

Infarct expansion and aneurysm (LVA) formation has poor prognosis. Traditional techniques of LV resection may be associated with suboptimal results, and do not fully restore LV geometry. LV endoaneurysmorrhaphy (LVEA) is newer operative technique which utilizes an endocardial patch to exclude the aneurysm and normalize LV geometry. Late clinical and echocardiographic features of these patients (pts) is unknown. We prospectively followed 51 consecutive pts who had undergone LVEA. Average duration of follow-up (F/U) was 4.6 years (range 2-10 years). All pts had clinical evaluation and review of medical records. Results: There were 2 (4%) peri-operative deaths, 2 (4%) in-hospital deaths, and 13 (24%) late deaths. Clinical improvement was noted in all 34 survivors: 30 surviving pts had F/U 2D echocardiograms (2DE). Near normal LV geometry was restored in all pts, and no patch aneurysms were noted at late F/U. 2DEs were adequate for quantitative analysis. The average LVEF post-op was 40.2% using the modified biplane analysis. Conclusions: LV endoaneurysmorrhaphy was associated with 72% over-all survival after average 4.6 year F/U. All survivors had improvement in clinical status and normalization of LV geometry.