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The Journal of Cardiovascular Surgery 1999 August;40(4):473-6

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Incidence of postinfarction aneurysm within one month of infarct. Experiences with sixteen patients in Hawaii

Premaratne S., Razzuk A. M.*, Koduru S. B., Behling A.**, McNamara J. J.**

From the Hunter Holmes McGuire Veterans Administration Medical Center and Department of Internal Medicine Medicine College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA * Department of Surgery and ** Department of Human Nutrition University of Hawaii at Manoa, Honolulu, Hawaii Department of Surgery, John A. Burns School of Medicine University of Hawaii at Manoa, Honolulu and Cardiovascular Research Laboratory The Queen’s Medical Center Honolulu, Hawaii


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Back­ground. We ­report on six­teen ­patients ­with a ­left ven­tric­ular aneu­rysm pre­senting at ­less ­than a ­month fol­lowing myo­car­dial infarc­tion.
­Methods. All ­patients had sig­nif­i­cant ­left ante­rior ­descending cor­o­nary ­artery dis­ease, and in ­eight ­cases (50%), ­this was the ­only sig­nif­i­cant ­pathology. Two ­patients who ­were ­treated con­ser­va­tively, ­died ­within ­three ­months of infarc­tion.
­Results. Of the four­teen sur­gi­cally ­treated ­patients, one ­died. ­There ­have ­been two ­late ­deaths, one at ten ­months and the ­other at ­four ­years ­postinfarc­tion. ­Patients who ­present ­early ­after infarc­tion, usu­ally ­have a ­large ante­rior aneu­rysm, ­requiring ­early sur­gical ­repair ­with ven­tric­ular aneu­rys­mec­tomy and revas­cu­lar­iza­tion. ­This ­group of ­patients ­showed a ­higher ­risk for ­major com­pli­ca­tions (­such as ­thrombo-embo­lism, arrhyth­mias) and/or ­death. Emer­gency cor­o­nary ­artery ­bypass sur­gery may ­prove ben­e­fi­cial in the pre­ven­tion of aneu­rysm for­ma­tion by revas­cu­lar­izing the ­viable but ­ischemic ­tissue in ­that ­area.

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