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June 1969

Postmyocardial Infarction Left Ventricular Aneurysm: Su rgical Management

Author Affiliations

From the Division of Surgery, Presbyterian-St. Luke's Hospital, and the University of Illinois College of Medicine, Chicago.

Arch Surg. 1969;98(6):766-770. doi:10.1001/archsurg.1969.01340120114021

Although the majority of patients suffering an initial myocardial infarction are able to resume relatively normal activities, a significant number are permanently incapacitated, and in many instances death results from myocardial necroses. Among the more lethal complications of myocardial infarction are ventricular rupture, rupture of the septum, disruption of the papillary muscle causing mitral insufficiency, mural thromboses with systemic embolization, and ventricular aneurysm. From a review of the literature it would appear that 73% of the patients with left ventricular aneurysm die within three years and 88% within five years of the date of their infarction.1 The vast majority (70%) of patients die of congestive heart failure.1

Recurrent myocardial infarction and thromboembolic phenomena are other common causes of death. Rupture of the aneurysm is quite rare. The increased incidence of congestive heart failure is the result of impaired left ventricular function. The paradoxical pulsation of the flaccid, noncontractile,

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