HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kron, I. L. Articles by DiMarco, J. P. Search for Related Content PubMed PubMed Citation Articles by Kron, I. L. Articles by DiMarco, J. P.

The Annals of Thoracic Surgery, Vol 54, 617-620, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Does a posterior aneurysm increase the risk of endocardial resection?

IL Kron, JA Kern, P Theodore, TL Flanagan, DE Haines, MJ Barber and JP DiMarco
Division of Thoracic and Cardiovascular Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.

The bias has been that the ideal anatomic circumstance for endocardial resection is the anterior left ventricular location. Posterior left ventricular aneurysms have been thought to be problematic to map and more difficult to close, and possibly to have a different substrate for ventricular tachycardia. To address this problem, we retrospectively reviewed the cases of 110 consecutive patients who underwent sequential endocardial resection for ventricular tachycardia between 1983 and 1991. Ninety-six patients had an anterior aneurysm, and 14 patients had a posterior aneurysm or infarct. Operative survival and 5-year survival were very similar between the two groups (p = not significant). A positive postoperative electrophysiological study was present in 11% of the anterior group versus 14% of the posterior group (p = not significant). There was a significantly greater incidence of mitral valve replacement in the posterior group, and we believe this was most likely due to frequent localization of the arrhythmia to the papillary muscle. Otherwise, patients with a posterior aneurysm or infarct had surgical results equivalent to those in patients with an anterior location. As long as there is a discrete aneurysm or infarct, endocardial resection is a safe and effective therapeutic procedure for ventricular tachycardia.

This article has been cited by other articles:

				W. L. Greene, J. Concato, and A. R. Feinstein Claims of Equivalence in Medical Research: Are They Supported by the Evidence? Ann Intern Med, May 2, 2000; 132(9): 715 - 722. [Abstract] [Full Text] [PDF]