Clinical Analysis Of Surgical Ventricular Aneurysm Restoration For Left Ventricular Aneurysm Combined With Coronary Artery Bypass Grafting

Objective:To clinical discussion of surgical ventricular restoration for left ventricular aneurysm combined with coronary artery bypass grafting. Methods:In this method review, 45 cases of clinical documents have been analyzed, which is due to left ventricular aneurysm combined with coronary artery bypass grafting from March,2004 to September. 2010. Male is 36 cases, and the rest female is 9 cases. Their Age is from 38 to 70 years old, and mean age is 55.1±6.3. The merge has several complications, which are 31 cases of unstable angina pectoris,14 cases of stable angina pectoris,9 cases of congested heart failure and 10 cases of ventricular arrhythmia. Once contracted with hypertension, diabetes, hyperlipemia and chronic blocking lung disease, is 35cases,4 cases,4 cases and 3 cases successively. Preoperative cardiac function was NYHA from class II to IV is 13 cases,25 cases and 7 cases successively.Having been implicated with the left coronary artery,the main branch and the left artery decending is 8 cases respectively. Uses the linear repair 21 examples, the ventricular reconstruction 24 examples, Combined With Coronary Artery Bypass Grafting, transplants bypass blood vessel 1-3 same time (2.2±0.7), the mitral valvuloplastyl example, the mitral valve replacement 2 examples,the thrombus elimination technique 12 examples, the average extracorporeal circulation time (137.8±11.1) min, blocks the ascending aorta (81.6±13.7)min. Results:Postoperative length of stay is (11.4±3.0) d, and postoperative length of stay in ICU is (2.25±1.1) d. The intra-operative use of intra-aortic balloon pump is in 6 cases. Compared with preoperative left ventricular end diastolic diameter being (62.1±5.0) mm, postoperative mean Left ventricular end diastolic diameter which is (56.9±3.9)mm is decreased significantly. Compared with preoperative left ventricular ejection fraction being(0.40±0.07), postoperative mean left ventricular ejection fraction which is (0.44±0.09)is decreased significantly. These differences are statistically significant (P<0.05). Conclusions: Surgical methods is an effective treatment of left ventricular aneurysm. the linear suture and Endocardial banding angioplasty may improve left ventricular morphology and functioned. According to the severity of left ventricular aneurysm, it is the key to choose reasonable surgical procedure.