The electrocardiogram after ventricular aneurysmectomy

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Surgical experience with ventricular aneurysmectomy alone or combined with coronary artery bypass surgery is accumulating.1–6 However, the electrocardiographic changes after aneurysm resection have been documented in only a few studies.7, 8 The purpose of this study was to define the spectrum of precordial electrocardiographic changes in a large population and to correlate such changes with clinical, angiographic, surgical, and pathological data.

Subjects and methods

At the Cleveland Clinic, between 1971 and 1976, 170 patients underwent resection of left ventricular aneurysm or scar without any other cardiac surgical procedure. Of these, the medical records of 104 patients contained both preoperative scalar electrocardiograms, as well as postoperative tracings done at least 3 weeks after the procedure. Fourteen patients were excluded from further study for the following reasons: five had complete right bundle branch block preoperatively; three had inferior or posterior ventricular aneurysms; four had “scars” or mixtures of “scar and muscle” rather than true aneurysms documented at surgery; and two had “false” or pseudoaneurysms. Thus, the 90 patients studied had true left ventricular aneurysms involving the septum, anterior, and/or apical myocardial walls.

The medical record of each patient was reviewed. The following data were extracted: age at operation, sex, symptoms and dates of myocardial infarction; coronary arterial lesions shown by angiography; left ventriculographic findings and preventriculographic left ventricular end-diastolic pressures. A coronary arterial lesion was considered important if at least 70% of the lumen was estimated to be obstructed. The operative reports were used to confirm the presence, location, and extent . . .



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