[Skip to Content]
[Skip to Content Landing]
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,

Schlichter, J.; Hellerstein, H.K.; and Katz, L.N.:  Aneurysm of the Heart: Correlative Study of 102 Proved Cases ,  Medicine 33:43-86 ( (Feb) ) 1954.Crossref
Hunter, J.: An Account of the Dissection of Morbid Bodys, a monograph or lecture, No. 32, pp 30-32, 1757 (available in Library of Royal College of Surgeons).
Applebaum, E., and Nicolson, G.H.B.:  Occlusive Disease of the Coronary Arteries: An Analysis of the Pathological Anatomy in 168 Cases, With Electrocardiographic Correlation in 36 of These ,  Amer Heart J 10:662-680 ( (June) ) 1935.Crossref
Bean, W.B.:  Infarction of the Heart: III. Clinical Course and Morphological Findings ,  Ann Intern Med 12:71-94 ( (July) ) 1938.Crossref
Wang, C.H.; Bland, E.F.; and White, P.D.:  A Note on Coronary Occlusion and Myocardial Infarction Found Postmortem at the MGH from 1926 to 1945 Inclusive ,  Ann Intern Med 29:601-606 ( (Oct) ) 1948.Crossref
Crawford, J.H.:  Aneurysm of the Heart ,  Arch Intern Med 71:502-515 ( (April) ) 1943.Crossref
Beck, C.S.:  Operation for Aneurysm of the Heart ,  Ann Surg 120:34-40 ( (July) ) 1944.Crossref
Bailey, C.P., et al:  Ventriculoplasty for Cardiac Aneurysm ,  J Thorac Surg 35:37-67 ( (Jan) ) 1958.
Petrovsky, B.V.:  Surgery for Aneurysms of the Heart After Myocardial Infarction ,  Arch Surg 84:397-408 ( (April) ) 1962.Crossref
Cooley, D.A., et al:  Ventricular Aneurysm After Myocardial Infarction: Surgical Excision With Use of Temporary Cardiopulmonary Bypass ,  JAMA 167:557-560 ( (May) ) 1958.Crossref
Lillehei, C.W., et al:  Resection of Myocardial Aneurysms After Infarction During Temporary Cardiopulmonary Bypass ,  Circulation 26:206-217 ( (Aug) ) 1962.Crossref
Effler, D.B., et al:  Surgical Treatment of Ventricular Aneurysm: Report of Ten Cases ,  Arch Surg 87:249-257 ( (Aug) ) 1963.Crossref
Lam, C.R., et al:  Diagnosis and Surgical Treatment of Postinfarction Left Ventricular Aneurysms ,  Dis Chest 49:628-637 ( (June) ) 1966.Crossref