The influence of surgery on the natural history of angiographically documented left ventricular aneurysm: the Coronary Artery Surgery Study.

Abstract:

:Coronary artery bypass surgery with or without aneurysmectomy has been used to treat patients with angiographically defined left ventricular aneurysm. To evaluate whether surgery benefits such patients, we analyzed the data from 1131 patients who were enrolled in the registry of the Coronary Artery Surgery Study. Four hundred sixty-seven patients underwent bypass surgery, of which 238 also had left ventricular resection, and 30 had resection alone. The overall operative mortality was 7.9%; the operative mortality was 7% for bypass alone compared with 9% for bypass surgery plus left ventricular resection (NS). Long-term survival by life-table analysis was similar for both medically and surgically treated patients (69% vs 67%, respectively). Cox survival analysis identified congestive heart failure score, duration of chest pain, extent of coronary disease, left ventricular end-diastolic pressure, age, and surgical therapy as important predictors of outcome. Patient subsets that showed improved survival with surgical therapy after adjustment for inequities in baseline characteristics were patients with three-vessel disease and those patients in moderate- and high-risk subgroups. Surgical therapy significantly reduced symptoms of angina and use of cardiac medications but the incidence of recurrent infarction was similar for both therapies.

journal_name

Circulation

journal_title

Circulation

authors

Faxon DP,Myers WO,McCabe CH,Davis KB,Schaff HV,Wilson JW,Ryan TJ

doi

10.1161/01.cir.74.1.110

subject

Has Abstract

pub_date

1986-07-01 00:00:00

pages

110-8

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

74

pub_type

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