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April 1982

Diaphragmatic Left Ventricular Aneurysm: Clinical Features, Surgical Treatment, and Long-term Follow-up in 22 Patients

Author Affiliations

From the Section of Cardiology, Departments of Medicine (Drs Codini, Ruggie, and Messer) and Cardiovascular Thoracic Surgery (Drs Goldin and Najafi), Rush-Presbyterian-St Luke's Medical Center, Rush Medical College, Chicago.

Arch Intern Med. 1982;142(4):711-714. doi:10.1001/archinte.1982.00340170067015

• Although the formation of a left ventricular aneurysm (LVA) is a common and well-recognized complication of myocardial infarction (MI), diaphragmatic LVA is a rare clinical entity. Of 354 consecutive patients who underwent LVA resection, we describe the clinical features and surgical results of 22 patients (6%) with diaphragmatic LVA. All patients had a history of MI. The principal clinical indication for surgery was heart failure in nine patients, angina pectoris in ten patients, and recurrent ventricular tachycardia unresponsive to medical therapy in three patients. A ventricular septal defect was present in two patients, and moderate to severe mitral regurgitation was present in four patients. Three of the four surgical deaths (operative mortality, 18%) occurred in patients with mitral regurgitation or with ventricular septal defect. Eleven patients are alive at a mean follow-up of 40 months. Six of them are asymptomatic and two have angina at a higher level of physical activity than before surgery. Notable differences exist in the clinical presentation and surgical findings between patients with diaphragmatic and anterior LVA.

(Arch Intern Med 1982;142:711-714)

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