Left Ventricular Aneurysm Repair: Long-Term Results of a Beating Heart Autologous Endoventriculoplasty Compared to Current Common Practice

F.R. Halfwerk*, Martin Jansen, Tomasz Plonek, J.G. Grandjean

*Corresponding author for this work

Research output: Contribution to conferenceAbstractAcademic

Abstract

Objectives: Left ventricular aneurysm (LVA) formation is a severe complication after transmural myocardial infarction. Over the last 60 years, different surgical ventricular reconstruction (SVR) techniques have been developed, but there still is no clear consensus about the most appropriate technique. This study analysed short and long-term outcomes of a new SVR technique by using autologous endocardium compared toother more commonly used techniques (e.g. plication, patch).

Methods: We retrospectively reviewed 95 patients receiving SVR due to a LVA between 2005 and 2019 in our centre. Patients underwent either onpump beating heart endoventriculoplasty using autologous endocardium as described by Grandjean (see Figure) or a more commonly used technique (e.g. patch, plication). Early surgical outcomes, long-term survival and postoperative cardiac function were compared.

Results: Mean age of patients was 67 [61 – 74] years. Pre-operative left ventricular ejection fraction (LVEF) was 33% [22 – 40%]. 52 (55%) patients had NYHA III/IV classification. No significant difference in baseline characteristics, in-hospital mortality or in-hospital complications were found. 1, 3 and 5-year postoperative LVEF in the autologous group were 40%, 43% and 36% compared to 45%, 44% and 39% in the
control group (p=0.21). Survival rates at 1, 5 and 10 year were 93%, 62% and 24%, and did not differ between groups.

Conclusions The new SVR technique, using autologous endocardium was noninferior compared to longer existing SVR techniques. Beating-heart SVR is feasible and can be used in patients with poor left ventricular function where aortic cross-clamp and subsequent ischemia might lead to problems with weaning from cardiopulmonary bypass.
Original languageEnglish
Number of pages1
Publication statusPublished - 10 May 2022
EventAnnual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland , SCTS 2022 - ICC, Belfast, United Kingdom
Duration: 8 May 202210 May 2022
https://scts.org/scts_annual_meeting/previous_meetings/scts_annual_meeting_2022.aspx

Conference

ConferenceAnnual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland , SCTS 2022
Abbreviated titleSCTS 2022
Country/TerritoryUnited Kingdom
CityBelfast
Period8/05/2210/05/22
Internet address

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