Treatment outcomes and therapeutic evaluations of patients with left ventricular aneurysm

J Int Med Res. 2019 Jan;47(1):244-251. doi: 10.1177/0300060518800127. Epub 2018 Oct 1.

Abstract

Objective: This study was performed to analyze and compare the efficacy of three treatment methods for left ventricular aneurysm (LVA): coronary artery bypass grafting (CABG) combined with left ventricular resection, drug treatment, and percutaneous coronary intervention (PCI).

Methods: In total, 183 patients with LVA from Fuwai Hospital were divided into three groups according to the treatment method: 51 patients underwent left ventricular resection combined with CABG (CABG-resection group), 65 underwent drug treatment (drug group), and 67 underwent PCI (PCI group). The clinical characteristics and survival rates of the patients were compared among the three groups.

Results: The patients' basic data and medical history were analyzed. The postoperative left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were significantly higher than those before surgery, indicating that the left ventricular function markedly improved after the operation.

Conclusion: Surgery is recommended as the first treatment option for LVA, and conservative therapy can be considered for selected patients. Although the difference was not statistically significant, CABG with left ventricular resection was associated with a better LVEF and LVEDD and higher survival and non-recurrence rates than PCI or drug treatment.

Keywords: Left ventricular aneurysm; coronary artery bypass grafting; left ventricular ejection fraction; left ventricular end-diastolic dimension; left ventricular resection; percutaneous coronary intervention.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass / mortality
  • Female
  • Follow-Up Studies
  • Heart Aneurysm / drug therapy
  • Heart Aneurysm / mortality
  • Heart Aneurysm / physiopathology
  • Heart Aneurysm / surgery*
  • Heart Ventricles / drug effects
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Percutaneous Coronary Intervention / mortality
  • Recurrence
  • Retrospective Studies
  • Stroke Volume / drug effects
  • Survival Analysis
  • Treatment Outcome
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / mortality
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery*

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors