Does On-pump beating heart endoaneurysmorrhaphy have advantages over linear aneurysmectomy on arrested heart in the short term?

Abstract

Background: It is still controversial which left ventricular aneurysm repair technique is optimal in terms of early and late results. This study aimed to compare early postoperative outcomes for 2 surgical treatments of postinfarction left ventricular aneurysm: linear repair technique on arrested heart versus endoaneurysmorrhaphy repair with patch plasty on beating heart.

Methods: Prospectively collected data from 16 consecutive patients who underwent endoaneurysmorrhaphy repair with patch plasty on beating heart (the technique we have preferred since 2008) were compared with data from a retrospective series of 10 patients who underwent linear repair on arrested heart (the technique we preferred until 2008). All operations were performed under elective conditions.

Results: Baseline characteristics of the 2 groups were similar. Complete revascularization for all diseased vessels was achieved in all patients. Durations of cross clamping, cardiopulmonary bypass, intensive care stay, and hospital stay were longer, and postoperative ejection fraction was lower, in the linear repair group compared with the endoaneurysmorrhaphy group (P < .05 for all). Early mortality occurred in 1 patient (3.8%) in the linear repair group.

Conclusion: Endoaneurysmorrhaphy repair with patch plasty on beating heart seems to offer advantages over the linear repair technique on arrested heart in the treatment of left ventricular aneurysms. Future large-scale prospective studies with longer follow-up are warranted to draw firm conclusions.