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Dor’s Surgery for Left Ventricular Aneurysm: Clinical Study

Kailash K. Bagale, Associate Professor, Department of CVTS, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka 560069, India. , Kalyane Ravikumar Nagashetty , Bagale Kailash K. , Seetharaman Rakesh , Kamalapurkar Giridhar ,

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Journal of Cardiovascular Medicine and Surgery 4(1):p 26-32, January - March 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4118.4

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Abstract

Aims: To find the early outcome following dor’s procedure for post infarct LV aneurysm. Settings and Design: This is a retrospective study of left ventricle aneurysm repair done at the Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, since June 2013 to September 2017. Methods and Material: Between June 2013 and September 2017, 23 patients underwent left ventricular aneurysm repair using Dor’s repair. The location of the left ventricular aneurysm was anterior (73.9%), apical (8.7%), posterior (17.4%). The indication for operation was congestive heart failure in all patients. Statistical Analysis Used: Anova and Bonferroni correctionTest was used to analyse the data obtained. Results: Intra-aortic balloon pumping was used postoperatively in 2 cases and 7 patients needed inotropic support for more than 24h. Mean time on the ventilator was 11.7± 3.6 hours and mean stay in the intensive care unit was 49.26 ± 13.7 hours. Overall mortality was 4.3% (one patient). Mean preoperative ejection fraction (EF) after surgery in was 37.9%. EF showed improvement after surgery to 49.23%. Decrease in end-diastolic volume (EDV) was from 111 ml/m2 to 69.19 ml/m2. Decrease in end-systolic volume was from 76.57 ml/ m2 to 45.76 ml/m2. All of these values showed statistically significant improvement. At the end of one month postoperatively, 83% of them were in NYHA class I and 17% were in class II. Conclusions: Dor’s repair is a reproducible surgical option for treatment of post infarction left ventricular aneurysm to restore its volume and geometry. Early results are good in terms of survival and functional improvement.

 

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4118.4

Keywords

LV Aneurysm; Dor’s Repair. 

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